A practical pressure measuring method for the upper urinary tract during ureteroscopy

Cai, Yi; Li, Xiaojuan; Zhu, Baoyi; Chen, Ruihan; Ye, Chunwei; Wang, Yu; Tao, Yiran; Sun, Qipeng; Wen, Xingqiao

doi:10.25011/cim.v35i5.18705

Cited by 9 publications

(19 citation statements)

References 18 publications

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“…During endoscopic surgery, when IRP exceeds 40 cm H 2 O, arterial blood flow decreases, insufficient venous pressure occurs, and associated renal oxidative damage increases [32]. In studies on semirigid URS, IRP reported is 68-272 cm H 2 O [33][34][35]. In the literature, after URS and fURS, the AKI markers tend to increase within the first 4-6 h postoperatively and then decrease [22,36].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Can Urinary KIM-1 and NGAL Predict Management Endoscopic Surgery in Acute Unilateral Obstructive Stone Disease? Results from a Prospective Cohort Study

et al. 2021

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Introduction: Kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) are the leading novel biomarkers used efficiently in acute kidney injury (AKI). The levels of these biomarkers increase especially in the early period of nephrotoxic and ischemic renal damage. In this study, we aimed to investigate the clinical importance of NGAL and KIM-1 biomarkers used in the effective evaluation of kidney functions in patients with acute unilateral obstructive stone disease (AUOSD) in the management of endoscopic surgery. Materials and Methods: We prospectively included patients who underwent endoscopic surgery due to AUOSD between January 2018 and December 2019. Urine KIM-1 and NGAL values of the patients were measured preoperative period, postoperative 4th h, and postoperative 7th day. The patients were evaluated according to the location and size of the stone, the degree of renal hydronephrosis, the duration of the operation, complications, and JJ stent placement. Results: The study enrolled 50 patients. Urinary KIM-1/Cr and urinary NGAL/Cr ratios were higher in postoperative 4th h than in others (p < 0.001). Also, we found that urinary KIM-1/Cr and urinary NGAL/Cr ratios with Grade 2 and higher hydronephrosis were statistically higher than Grade 0–1 hydronephrosis (p < 0.001 and p: 0.042, respectively). Additionally, a preoperative urinary KIM-1 value of 1.24 ng/mL had a sensitivity of 78% and a specificity of 63% to predict the presence of hydronephrosis. When urine KIM-1 and NGAL results were compared with surgery time, stone size and location, serum creatinine (sCr) value, and Post-Ureteroscopic Lesion Scale grade, the difference was not statistically significant. Postoperative 7th day NGAL/Cr and KIM-1/Cr ratios were statistically higher in those with JJ stents placed (p: 0.03 and p: 0.004, respectively). Conclusion: KIM-1 and NGAL can be used in our assessment of renal function in patients with AUOSD, even if sCr is normal. Also, these biomarkers can predict the presence of hydronephrosis. It can be helpful in determining the time of surgical treatment, as well as providing information in the follow-up of patients with JJ stents after treatment.

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Section: Discussion/conclusionmentioning

confidence: 99%

Can Urinary KIM-1 and NGAL Predict Management Endoscopic Surgery in Acute Unilateral Obstructive Stone Disease? Results from a Prospective Cohort Study

et al. 2021

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“…Few studies evaluated upper tract pressure using different methods [ 4 , 5 ]. Shafik used 3-Fr ureteric catheter to measure the ureteral pressure via a transducer output recorded on a rectilinear recorder [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Intravesical aminophylline instillation as an alternative for balloon dilatation prior to semi-rigid ureteroscopic management of distal ureteral stones

et al. 2022

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Purpose In a randomized controlled trial, we evaluated the effect of intravesical aminophylline instillation (IVAI) on intraureteral pressure of lower ureter and its use as an alternative to balloon dilatation after failure of advancing semi-rigid ureteroscope through the ureteric orifice without endodilatation. Methods Our study included 83 patients with juxta-vesical distal ureteral calculi requiring endodilatation after unsuccessfully introducing the semi-rigid ureteroscope through the ureteric orifice. Patients were randomized into two groups: group A (study group) included 41 patients, where IVAI was used to dilate the ureter and facilitate ureteroscopy (the intraureteral pressure was measured using a pressure transducer connected to an invasive pressure monitor before and 5 min after IVAI), whereas group B (control group) included 42 patients, where balloon dilatation was used prior to ureteroscopy. Perioperative surgical outcomes of ureteroscopy were evaluated in both groups. Results A statistically significant decrease in mean intraureteral pressure of intravesical ureter was found after IVAI from 12.34 mmHg ± 1.94 before injection to 8.46 mmHg ± 1.94 after injection (P < 0.001). Ureteral injuries, postoperative pain and hematuria were statistically significantly less among the study group compared to the control group (P < 0.05). We did not find statistically significant differences in operative time, need for DJ ureteral stenting or stone-free rate between both groups and no perioperative side effects were associated with IVAI. Conclusion In ureteroscopic management of distal ureteral stones, intravesical aminophylline instillation is safe, inexpensive and effective in reducing intraureteral pressure and achieves comparable outcomes to balloon dilatation with less ureteral injuries, postoperative pain and hematuria.

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“…One of them is the wireless sensing performance. The reported pressure changes induced by hydronephrosis [ 24 ] suggest that a sensing resolution of 10 mmHg or less is likely required to detect a sign of the problem, while this was observed to be ≈30 mmHg with the current proof‐of‐concept and tended to deteriorate as the device was placed in a more conductive medium (artificial urine) and/or with increased D AS . One effective approach to addressing this factor is to raise the Q factor of the stent device.…”

Section: Discussionmentioning

confidence: 99%

“…The internal pressure of a kidney is reported to range, on average, from 10.2 mmHg at a normal condition to 32.5 mmHg with chronic ureteral obstruction and to 74.5 mmHg with acute ureteral obstruction. [ 24 ] Traditionally, kidney pressure was characterized using a methodology known as the Whitaker test. [ 31,33 ] This method combines urodynamics with antegrade pyelography to measure the differential pressure between the renal pelvis region in kidney and the bladder using two pressure transducers separately inserted into these sites percutaneously.…”

Section: Introductionmentioning

confidence: 99%

“…[18,23] In certain cases, hydronephrosis deteriorates to result in the build-up of crystals inside and outside the stent, which, in turn, can lead to blocking of the ureter [21] and further to damaging of the kidney due to its increased pressure. [24] Although the studies of drugeluting and surface-modified stents have shown promise in preventing hydronephrosis, [23,25,26] their usage has been limited due to challenges in infectious urinary settings as well as coating reliability. [23,25] Given the possibility that untreated hydronephrosis could cause permanent kidney damage and subsequent loss of kidney function, early diagnosis is a singularly important factor, particularly when patients happen to be asymptomatic.…”

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confidence: 99%

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Intelligent Ureteral Stent for Early Detection of Hydronephrosis

Darestani

Shalabi

Lange

et al. 2021

Adv Materials Technologies

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Millions of people around the world currently suffer from kidney stone diseases. While ureteral stenting is an unmistakably effective treatment of these patients, their long‐term adverse effects can result in the build‐up of crystals around the stent. This, in turn, can lead to new ureter blockages that can dangerously increase kidney pressure, a condition known as hydronephrosis, which, if severe and prolonged, can cause irreversible kidney damage. Toward enabling early detection of hydronephrosis, this paper investigates the first intelligent ureteral stent with an integrated radiofrequency antenna and micro pressure sensor for resonance‐based wireless tracking of kidney pressure. Prototyping is conducted using a commercial ureteral stent as the substrate for microfabrication of the device. The packaged device is experimentally assessed for electrical characterizations and wireless pressure sensing using an in vitro test model. Preliminary telemetry testing demonstrates the fundamental ability of the device with its approximately linear responses of up to 1.7 kHz mmHg−1 over a pressure range of up to 120 mmHg in air, water, and artificial urine. These findings verify the efficacy of the device design and the approach to kidney pressure monitoring through indwelling stents, paving the way for the transfer of this technology to today's ureteral stent products.

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A practical pressure measuring method for the upper urinary tract during ureteroscopy

Cited by 9 publications

References 18 publications

Can Urinary KIM-1 and NGAL Predict Management Endoscopic Surgery in Acute Unilateral Obstructive Stone Disease? Results from a Prospective Cohort Study

Can Urinary KIM-1 and NGAL Predict Management Endoscopic Surgery in Acute Unilateral Obstructive Stone Disease? Results from a Prospective Cohort Study

Intravesical aminophylline instillation as an alternative for balloon dilatation prior to semi-rigid ureteroscopic management of distal ureteral stones

Intelligent Ureteral Stent for Early Detection of Hydronephrosis

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