Simultaneous Measurement of Pressure in the Calyces During RIRS in a Human Cadaver Model
Journal Title: Journal of Urological Surgery - Year 2019, Vol 6, Issue 3
Abstract
Objective: The aim of this study was to evaluate calyceal pressure caused by irrigation of the upper, mid and lower calyces in a cadaver kidney model and to examine the interactions. Materials and Methods: The kidney was dissected together with the ureter from a human cadaver from a 75-year-old without a history of renal disease. Catheters were placed in the bases of the calyces to perform pressure measurements. After recording baseline pressures while the flexible ureteroscope working channel was empty during irrigation, pressures were then measured by administering fluid with a hand pump, 5 cc and 50 cc syringe. Then, 272 μ and 350 μ laser probes were placed in the flexible ureteroscope and, after recording the baseline calyceal pressures, the measurements were repeated 3 times during hand pump irrigation. Results: Lowest calyceal pressures were measured when a 300 μ laser probe in the working channel of the flexible ureteroscope was placed in the upper calyx during irrigation at 60 cm H2O. Independent of the location of the flexible ureteroscope, the pressure in all the calyces was observed to be ≥50 mmHg during all types of fluid irrigation. All the calyceal pressures were observed to be affected by each other. The pressure within the calyx where the flexible ureteroscope was located was statistically significantly higher than in the other calyces (p<0.001). Conclusion: Application of additional fluid irrigation during flexible ureteroscopy causes a serious increase in intrarenal pressure. If fluid irrigation is to be applied, it should be done using a very small amount of fluid and for a very short duration.
Authors and Affiliations
Aykut Aykaç, Özer Baran, Zülal Öner, Çoşkun Kaya, Uğur Özok, Melih Sunay
Keywords
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- EP ID EP50493
- DOI 10.4274/jus.galenos.2019.2412
- Views 238
- Downloads 0
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