The Normal Pressure-Flow Relationship of Pyeloureter in the Pig

Mortensen, J.; Bisballe, Søren; Tm, Jørgensen; Tågehøj-Jensen, F.; Jc, Djurhuus

doi:10.1159/000280799

Cited by 10 publications

(4 citation statements)

References 5 publications

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“…This study showed that the pressure‐flow relationship of the renal pelvis during ureterorenoscopy was linear, which is in accordance with previous studies on the normal pressure‐flow relationship, by Mortensen et al. [1,20]. In these studies a ureteroscope was not used, and the mean pelvic pressure was 25.5 mmHg at a perfusion rate of 20 mL/min.…”

Section: Discussionsupporting

confidence: 91%

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Endoluminal isoproterenol reduces renal pelvic pressure during semirigid ureterorenoscopy: a porcine model

et al. 2009

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were recorded. The increase in renal pelvic pressure was examined with increasing flow rates (0, 4, 8,12,16, 25 and 33 mL/min) with saline alone or saline + ISO 0.1 μ g/mL. Perfusion was initiated on the left side, with randomization for adding ISO or not. Thereafter perfusion was done on the right side as a control in each pig. The surgeons were unaware of whether ISO was added or not. RESULTSThe mean ( SD ) baseline pelvic pressures in the saline and ISO group were 28 (7.1) and 25 (9.8) mmHg, respectively, with no significant difference ( P = 0.079). Endoluminal perfusion with ISO significantly inhibited the pelvic pressure increase to perfusion at all perfusion rates. The pressureflow relation was linear; the maximum relaxation (27%) was obtained at 4 mL/min, from 52 to 38 mmHg during saline alone and ISO 0.1 μ g/mL perfusion, respectively. The mean blood pressure did not change significantly ( P = 0.330). The mean ( SD ) heart rate in the saline and ISO group were 109 (4.5) and 97 (2.1) beats/min, respectively ( P < 0.001), i.e. a markedly greater rate in the saline than in the ISO group. CONCLUSIONThe pressure-flow relation during semirigid ureterorenoscopy was linear. ISO 0.1 μ g/mL in saline significantly reduced the pressure-flow relation during semirigid ureterorenoscopy in this porcine model. ISO might be a potential additive to the irrigation fluid during upper urinary tract endoscopic procedures, minimizing pressure increases due to irrigation and manipulation. KEYWORDSisoproterenol, pelvic pressure, endoluminal perfusion, ureterorenoscopy, cardiovascular function OBJECTIVETo investigate the effects on the pressureflow relation of renal pelvic pressure during semirigid ureterorenoscopy and endoluminal perfusion of isoproterenol (ISO) 0.1 μ g/mL, with emphasis on local effects and cardiovascular side-effects, as topically administered ISO effectively and dosedependently causes relaxation of the upper urinary tract in pigs with no concomitant cardiovascular side-effects.

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Section: Discussionsupporting

confidence: 91%

“…The normal pelvic pressure in pigs is well characterized and is 5–15 mmHg [1], and comparable to pressures in man [2]. The pressure‐flow relationship in the normal porcine ureter has been investigated and shows a characteristic phased increase in pressure during endoluminal perfusion [3].…”

Section: Introductionmentioning

confidence: 99%

Endoluminal isoproterenol reduces renal pelvic pressure during semirigid ureterorenoscopy: a porcine model

et al. 2009

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“…Normal renal pelvic pressure varies between 5-15 mmHg [2,3]. The pressure can rise to approximately 410 mmHg during URS.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Ureterorenoscopy on Renal Function

Aldemir¹,

Önen²,

Kayıgίl³

2010

UIJ

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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

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“…An increase in the renal pelvic pressure tends to occur during endoluminal saline irrigation, which is familiar in endoscopy of the upper urinary tract such as percutaneous nephrolithotomy (PCNL) and ureterorenoscopy [2,3,4]. Renal pelvic pressure has been shown to reach a value of even up to 410 mm Hg during flexible ureteroscopy in humans [2].…”

Section: Introductionmentioning

confidence: 99%

Verapamil Inhibits the Pelvic Pressure Increase Corresponding to Flow Perfusion in the Porcine Percutaneous Renal Puncture Model

Shao¹,

Wei²,

M³

et al. 2016

Urol Int

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Purpose: To estimate the effects of verapamil on pelvic pressure and investigate the possible systemic side effects in the porcine model during the procedure of increasing perfusion rates. Materials and Methods: In the experimental group, the pelvic pressure was recorded with increasing perfusion rates of the renal pelvis (0, 2, 4, 6, 8, 10, 14 and 20 ml/min) in response to intraluminal administration of increasing concentrations of verapamil (0, 0.1, 1, 10 and 100 µg/ml) in isotonic saline. In the isotonic saline group, the pressure flow study was also done by increasing perfusion rates of the renal pelvis per animal using isotonic saline without verapamil. Results: Perfusion with 1, 10 and 100 µg/ml verapamil caused a decrease in pelvic pressure as a response to increasing flow rates, whereas perfusion with 0.1 µg/ml verapamil did not obviously inhibit the increase of pelvic pressure at all perfusion rates compared with other concentrations. Importantly, the mean systolic blood pressure and mean heart rate were stable despite the increase of flow rates and verapamil concentrations. In the isotonic saline group, perfusion with isotonic saline resulted in an increase in the pelvic pressure with an increase in flow rates each time. Conclusions: Endoluminal administration of verapamil reduces pelvic pressure significantly without any untoward systemic cardiovascular side effects.

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The Normal Pressure-Flow Relationship of Pyeloureter in the Pig

Cited by 10 publications

References 5 publications

Endoluminal isoproterenol reduces renal pelvic pressure during semirigid ureterorenoscopy: a porcine model

Endoluminal isoproterenol reduces renal pelvic pressure during semirigid ureterorenoscopy: a porcine model

The Effects of Ureterorenoscopy on Renal Function

Verapamil Inhibits the Pelvic Pressure Increase Corresponding to Flow Perfusion in the Porcine Percutaneous Renal Puncture Model

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