Intrarenal Pressure Measured Using a Novel Flexible Ureteroscope with Pressure Sensing Capabilities: A Study of the Effects of Ureteral Access Sheath, Irrigation, and Working Channel Accessories

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Ben H. Chew - , University of British Columbia (Author)
  • Nabil Shalabi - , University of British Columbia (Author)
  • Roman Herout - , Department of Urology, University of British Columbia (Author)
  • Alina Reicherz - , University of British Columbia, Ruhr University Bochum (Author)
  • K. F.Wong Victor - , University of British Columbia (Author)
  • Kyle Searles - , University of British Columbia (Author)
  • Naeem Bhojani - , University of Montreal (Author)

Abstract

Introduction: Intrarenal pressure is emerging as an important monitoring parameter during flexible ureteroscopy (fURS). We measure how intraoperative conditions affect intrarenal pressure using a novel pressure sensing ureteroscope. Methods: The LithoVue Elite (LVE) single-use digital flexible ureteroscope (Boston Scientific) is the first commercial ureteroscope that senses pressure at its tip. LVE was used in a porcine model to measure intrarenal pressure with and without a ureteral access sheath (UAS) with various sizes and placement locations, irrigation methods, and working channel accessories. LVE pressure accuracy was measured in a bench model. This abstract shows the least-square means from multiway analysis of variances used for analysis. Results: Intrarenal pressures were the highest without a UAS (64 mm Hg), followed by the 11/13 UAS (51 mm Hg) and the 12/14 and 13/15, which were not statistically different (39–40 mm Hg). The pressures were highest with UASs placed at the ureteropelvic junction (61 mm Hg), and lowest if placed in the renal pelvis (24 mm Hg). Irrigation methods showed the highest pressures with syringe (57 mm Hg), while irrigation bags (pressurized at 150–300 mm Hg) produced 43 to 46 mm Hg and 25 mm Hg when applied with 80 cm of gravity. Placing a 200 lm laser fiber reduced pressures from 44 to 41 mm Hg. Finally, the bench model showed that LVE was 96% accurate up to 300 mm Hg. Conclusion: Intrarenal pressure significantly varied based on UAS sizes, placement, and irrigation methods. Accordingly, fURS with LVE is poised to be an invaluable tool for clinical decision-making and future studies of intrarenal pressure.

Details

Original languageEnglish
Pages (from-to)1200-1208
Number of pages9
JournalJournal of Endourology
Volume37
Issue number11
Publication statusPublished - 1 Nov 2023
Peer-reviewedYes

External IDs

PubMed 37725581

Keywords

ASJC Scopus subject areas

Keywords

  • intrarenal pressure, LithoVue Elite, ureteral access sheath, ureterorenoscopy, urolithiasis

Library keywords