Measurement of renal pelvis pressures during endourologic procedures

Upper urinary tract pressures in endourology: a systematic review of range, variables and implications

“…-Fr sheaths and pressurized irrigation at 204-340 cmH 2 O reported mean IRPs of 26.5 AE 7.9 (with suction)[36], 33.8 AE 9.7[64] and 34.7 AE 5.5[65] with 79.7-100% of patients experiencing pressures Additional factors influencing IRPs during PCNL Ureteric drainage Saltzman et al did not note a significant difference in IRP during standard PCNL with the use of a 6-Fr ureteric catheter (urethral catheter also present)[62]. The placement of an 11/13-Fr or 12/14-Fr UAS, however, was shown to reduce maximum IRP experienced during 30-Fr sheath PCNL to 15 cmH 2 O, from the 30-40 cmH 2 O value observed with an empty ureter, in one ex vivo study[70].…”

Irrigation with isoproterenol diminishes increases in pelvic pressure without side-effects during ureterorenoscopy: A randomized controlled study in a porcine model

“…The ability to reduce the pelvic pressure beneath the critical level for intrarenal backflow may have clinical benefits. The potential consequences of high pressures in the upper urinary tract have previously been studied [2,3,6]. A high constant intrarenal pressure increases the severity of intrarenal backflow and may result in infectious complications and damage to the kidney parenchyma [1,5,6,8].…”

“…Theoretically, knowing the potential harm of high intrarenal pressures [2,5,6], it would seem important to keep the pelvic pressure as low as possible during endoscopy, even if it is not possible to maintain the pressure below the level for renal backflow. In addition, relaxation of the ureteral smooth muscles during ureterorenoscopy may facilitate the procedure and improve safety.…”

Two different volume of local anaesthetic in subarachnoid block for Minipercutaneous Nephrolithotomy in prone position

“…If surgery is allowed to proceed with this level regression of the block may cause pain sensation before the surgery is accomplished. The pulsatile pressurized irrigation through the endoscope during MPCNL with a pressure as high as 350 mm of Hg provides a clean view and allows fl ushing out of stone fragments 20 . On the other hand this much of pressure distends the calyceal system and stretches the tissues causing discomfort and pain to patients if suffi cient sensory level is not achieved.…”