Monitoring renal pelvic pressure during retrograde intrarenal surgery with syringe irrigation

Abstract

Objective To monitor intraluminal renal pelvic pressure during retrograde intrarenal surgery(RIRS) with syringe irrigation and to investigate the safety of this irrigation method. Methods Seven patients admitted for the flexible ureteroscopic lithoripsy with indwelling nephrostomy tube were enrolled.Two males and 5 femals, with the age from 29 to 58 years (median 48 years). The renal pelvic pressure was measured by the pressure transducer during RIRS. Results In the 7 cases, the mean intra-pelvic pressure(IPP) ranged from 5.1 to 54.8 cm H2O, the maximum intra-pelvic pressure(IPPmax) ranged from 12 to 158 cmH2O, the time of lithotripsy ranged from 8.25 to 54.73 min (median 23.12 min), the water consumption ranged from 250 to 2300 ml(median water consumption 640 ml), and the mean irrigation rate ranged from 27.19 to 40.02 ml/min (median irrigation rate 31.14 ml/min), respectively. Conclusions The intraluminal renal pelvic pressure during retrograde intrarenal surgery (RIRS) with syringe irrigation can be controlled at a low level. The cooperation of pushing water during RIRS by the assistant is crucial. The syringe irrigation method has the advantages of controllable pressure, a rapid adjustment, negative pressure suction in necessity and short duration of high pressure. Key words: Renal pelvic pressure; Flexible ureteroscope; Lithotripsy