The Effects of Ureterorenoscopy on Renal Function

Abstract

Abbreviations and AcronymsCRP = c-reactive protein DJ = double J URS = ureterorenoscopy ABSTRACT INTRODUCTION: The effects of dilatation and increased pressure in the ureter and renal pelvis following ureterorenoscopy (URS) are not well documented. The purpose of the prospective study was to evaluate renal function in patients undergoing URS for treatment of ureteral calculi. METHODS: URS was performed on 30 patients between March and June, 2009. The mean (SD) patient age was 38.8 (12.2) years. There were 23 males and 7 females. Biochemical tests of renal function in the serum and urinewere performed before the URS and on the 7 th postoperative day. Outcome measures were compared before and after URS for all patients, and separately for patients with or without a double-J stent, using paired t tests.Probability < .003 indicated significant differences, following a Bonferroni adjustment. RESULTS:Out of 17 measures of renal function, there was a significant postsurgery increase in the amount of proteinuria excreted in the 24-hour urine (P = .001). Ureteral stents were inserted in 19 (63%) patients. Patients with and without DJ stents had a significant increase in proteinuria in 24-hour urine (P = .001 for both patient groups). There were no other significant differences. The mean URS duration was 40 minutes. The mean amount of serum physiological fluid consumed was 1860 mL (SD, 1474.2; range, 250-7500 mL). A pneumatic lithotripter was used in 27 (90%) of the cases to shatter the calculi. There were no surgical complications or significant changes in arterial blood pressure. CONCLUSIONS:The URS procedure did not significantly alter any measure of renal function except for urine proteinuria in 24 hours, which increased following surgery for patients with or without DJ stents. UroToday International Journal ® UI J