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What is it about?
In this study, the pressure range generated in the human renal collecting system during ureteroscopy (URS) was evaluated, and the relationship between intrarenal pressure (IRP) and outcome was investigated. A total of 120 adult patients undergoing semi-rigid URS and/or flexible ureterorenoscopy (FURS) were included. The mean (SD) baseline IRP was 16.45 (5.99) mmHg, and the intraoperative IRP varied by technique. The highest single pressure peak was 334.2 mmHg, during retrograde pyelography. Elevated IRP was found to be associated with postoperative urosepsis.
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Why is it important?
This research is important because it sheds light on the pressure range generated in the human renal collecting system during ureteroscopy (URS) and investigates the relationship between intrarenal pressure (IRP) and outcome. This is the first study of its kind, addressing the knowledge gap regarding irrigation flow, intrarenal pressure, and their effect on post-procedure patient outcomes. The findings of this study provide valuable insights into the intrarenal pressure dynamics during URS, which can help improve patient outcomes and minimize the risk of postoperative complications. Key Takeaways: 1. A dynamic IRP profile is observed during human in vivo URS, with IRP frequently exceeding expected thresholds. 2. Elevated IRP is associated with postoperative urosepsis. 3. Baseline IRP values in lithotomy position exhibit a mean (SD) value of 16.45 (5.99) mmHg, and are slightly higher in male vs female patients. 4. Intraoperatively, wide SDs were noted, indicating a high level of variability in IRP, which may reflect additional confounders to irrigation settings and outflow drainage. 5. The shortest length UAS that reaches the patient's PUJ may result in the most efficient drainage.
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This page is a summary of: In vivo ureteroscopic intrarenal pressures and clinical outcomes: a multi‐institutional analysis of 120 consecutive patients, BJU International, September 2023, Wiley,
DOI: 10.1111/bju.16169.
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