Fluid Absorption during Ureterorenoscopy

Cybulski, Peter; Honey, R. John D'a.; Pace, Kenneth T.

doi:10.1089/end.2004.18.739

Cited by 40 publications

(7 citation statements)

References 7 publications

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“…Also, our model could not account for some possible uid absorption. However, since there were no urothelial lesions we believe that uid absorption was minimal, as previously described [25], and we do not think it could have impacted different kidney locations in a different manner. Furthermore, we only used two UAS and one 9.5Fr ureteroscope, which is now the most often used scope size for fURS.…”

Section: Discussionsupporting

confidence: 51%

Determinants of outflow rate during flexible ureteroscopy: an experimental in vivo study in an anesthetized porcine model

Faria-Costa

Tsaturyan

Peteinaris

et al. 2022

Preprint

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Purpose: To evaluate the effect of different ureteroscope positions, saline pumping frequency, laser fiber diameter and ureteral access sheath (UAS) on outflow rate during flexible ureteroscopy (fURS). Material and Methods: This study was performed in an anesthetized porcine model. The fURS setup included a manual pumping system, a 9.5Fr single used-digital flexible ureteroscope and a ureteral access sheath (UAS). Outflow was collected and measured from the UAS during 1 minute in all experimental settings. The evaluated variables were the position of the ureteroscope, the pumping frequency (2s, 3s or 5s), the diameter of the used UAS (12/14Fr or 14/16Fr) and laser fiber (200 μm or a 272 μm). Results: Ureteroscope position in the lower calyx was associated with significantly lower outflow rate (p<0.05). The use of the 14/16Fr UAS resulted in improved flow in the renal pelvis and upper calyx (p<0.05) but not in the lower calyx. The use of a 200 μm laser fiber only improved flow in the upper calyx and when a 14/16Fr UAS was being used.Pumping frequency did not show a significant correlation with outflow rate.Conclusions: The ureteroscope positioning and UAS size were important determinants of outflow rate during fURS, while laser fiber diameter had a limited effect. In the lower calyx the outflow was minimal and was not improved by using a larger UAS.

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Section: Discussionsupporting

confidence: 51%

Determinants of outflow rate during flexible ureteroscopy: an experimental in vivo study in an anesthetized porcine model

Faria-Costa

Tsaturyan

Peteinaris

et al. 2022

Preprint

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“…The intrarenal fluid reabsorption during URS has also been indirectly proved in humans by Cybulski et al [ 22 ], by measuring fluid instilled into and collected from the urinary tract, with a mean estimated systemic fluid absorption during URS of 54 mL (range 4–137 mL).…”

Section: Discussionmentioning

confidence: 94%

Understanding the Role of Ureteral Access Sheath in Preventing Post-Operative Infectious Complications in Stone Patients Treated with Ureteroscopy and Ho:YAG Laser Lithotripsy: Results from a Tertiary Care Referral Center

Villa

Dioni

Candela

et al. 2023

JCM

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Introduction and objectives: The use of ureteral access sheaths (UAS) limits the irrigation-induced increase in intrarenal pressure during ureteroscopy (URS). We investigated the relationship between UAS and rates of postoperative infectious complications in stone patients treated with URS. Materials and methods: Data from 369 stone patients treated with URS from September 2016 to December 2021 at a single institution were analyzed. UAS (10/12 Fr) placement was attempted in case of intrarenal surgery. The chi-square test was used to assess the relationship between the use of UAS and fever, sepsis, and septic shock. Univariable and multivariable logistic regression analyses tested the association of patients’ characteristics and operative data and the rate of postoperative infectious complications. Results: Full data collection of 451 URS procedures was available. Overall, UAS was used in 220 (48.8%) procedures. As for postoperative infectious sequalae, we recorded fever (n = 52; 11.5%), sepsis (n = 10; 2.2%), and septic shock (n = 6; 1.3%). Of those, UAS was not used in 29 (55.8%), 7 (70%), and 5 (83.3%) cases, respectively (all p > 0.05). At multivariable logistic regression analysis, performing URS without UAS was not associated with the risk of having fever and sepsis, but it increased the risk of septic shock (OR = 14.6; 95% CI = 1.08–197.1). Moreover, age-adjusted CCI score (for fever-OR = 1.23; 95% CI = 1.07–1.42, sepsis-OR = 1.47; 95% CI = 1.09–1.99, and septic shock-OR = 1.61; 95% CI = 1.08–2.42, respectively), history of fever secondary to stones (for fever-OR = 2.23; 95% CI = 1.02–4.90) and preoperative positive urine culture (for sepsis-OR = 4.87; 95% CI = 1.12–21.25) did emerge as further associated risk factors. Conclusions: The use of UAS emerged to prevent the onset of septic shock in patients treated with URS, with no clear benefit in terms of fever and sepsis. Further studies may help clarify whether the reduction in fluid reabsorption load mediated by UAS is protective against life-threatening conditions in case of infectious complications. The patients’ baseline characteristics remain the main predictors of infectious sequelae in a clinical setting.

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“…This is related to the time it takes for the alcohol to absorb and evaporate from the gas. Additionally, the baseline absorption, even with a breath ethanol level of zero, has been estimated to be 44 mL per 10-minute interval based on the development of these formulas [7]. Therefore, when the absorption amount is less than 44 ml, the default is no liquid absorption.…”

Section: Discussionmentioning

confidence: 99%

Fluid absorption during flexible ureteroscopic lithotripsy with intelligent control of renal pelvic pressure: A prospective randomized controlled trial

Deng,

Chen,

Song

et al. 2023

Preprint

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Objective: To investigate fluid absorption and its influencing factors during flexible ureteroscopic lithotripsy with intelligent control of renal pelvic pressure (RPP). Methods: A total of 80 patients with upper urinary tract calculi underwent flexible ureteroscopic lithotripsy with intelligent control of RPP and were randomly divided into four groups. The RPP of Groups A, B, and C were set at -5 , 0 and 5 mmHg, respectively. Conventional flexible ureteroscopic lithotripsy with uncontrolled pressure served as control Group D. The perfusion flow rate was set at 100 ml/min in the four groups, with 20 patients in each group. The fluid absorption was measured by 1% ethanol every 10 minutes. Operation time, stone-free rate, and complications were recorded. Result: Seventy-three patients were finally included in the RCT. The general and preoperative data of the patients were comparable between the groups. The fluid absorption of Groups A, B, and C was significantly less than that of Group D (P < 0.01). Fluid absorption and operation time were positively correlated, and the correlation coefficients R were 0.864, 0.896, 0.918, and 0.947, respectively (P<0.01). The fluid absorption of patients with vomiting, fever and ureteral injury was greater than that of patients without complications in the four groups (P < 0.01). In different groups, fluid absorption was greater in patients with ureteral injury PULS 1-3 than in noninjured patients (P<0.01). CONCLUSION: Flexible ureteroscopic lithotripsy with intelligent control of RPP effectively reduces the absorption of perfusion fluid. Operation time and ureteral injury are also key factors affecting perfusion fluid absorption.

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Fluid Absorption during Ureterorenoscopy

Cited by 40 publications

References 7 publications

Determinants of outflow rate during flexible ureteroscopy: an experimental in vivo study in an anesthetized porcine model

Determinants of outflow rate during flexible ureteroscopy: an experimental in vivo study in an anesthetized porcine model

Understanding the Role of Ureteral Access Sheath in Preventing Post-Operative Infectious Complications in Stone Patients Treated with Ureteroscopy and Ho:YAG Laser Lithotripsy: Results from a Tertiary Care Referral Center

Fluid absorption during flexible ureteroscopic lithotripsy with intelligent control of renal pelvic pressure: A prospective randomized controlled trial

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