You have accessJournal of UrologyStone Disease: Basic Research1 Apr 20101975 ACUTE EFFECTS OF URETERAL STONE OBSTRUCTION IN A SOLITARY KIDNEY OR IN THE PRESENCE OF A NORMAL CONTRALATERAL KIDNEY: CHANGES IN THE RENAL RESISTIVE INDEX AND URETERAL DYNAMICS IN AN IN VIVO PORCINE MODEL Ramakrishna Venkatesh, Nitin Das, Steven LaBarbera, Geneva Baca, Ahmed Tawfik, and Robert S. Figenshau Ramakrishna VenkateshRamakrishna Venkatesh Lexington, KY More articles by this author , Nitin DasNitin Das St. Louis, MO More articles by this author , Steven LaBarberaSteven LaBarbera St. Louis, MO More articles by this author , Geneva BacaGeneva Baca St. Louis, MO More articles by this author , Ahmed TawfikAhmed Tawfik St. Louis, MO More articles by this author , and Robert S. FigenshauRobert S. Figenshau St. Louis, MO More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1985AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Studying acute changes in ureteral activity and renal hemodynamics following ureteral stone obstruction in a solitary kidney or bilateral system may be important in the management of patients with stone colic. We studied ureteral peristalsis, intrapelvic pressure(IPP) and renal resistive index (RI) in an in vivo porcine model. METHODS Twenty four domestic pigs were divided into 4 groups: animals with ureteral stone and normal contralateral system, animals with solitary kidney but no ureteral stone, animals with ureteral stone in a solitary kidney and controls with normal kidneys and no stone. Peristalsis was studied by a magneto-resistive sensor and EMG electrodes deployed on to the ureteral surface via a lumbotomy incision. The IPP was measured by a transducer in the renal pelvis and RI by Duplex ultrasound. In the solitary kidney group, laparoscopic nephrectomy was performed before studying the contralateral ureter. Urine output was also recorded before and for 5 hours after placement of an appropriate sized stone in the proximal ureter. RESULTS The average urine output in all animal groups was 156 mls/hr except the solitary kidney with ureteral stone group(95 mls/hr). There was increase in the median rate of peristalsis in animals with ureteral stone, both in the unilateral and bilateral systems (13.5/10min.) compared to those without ureteral stone (8/10min). The median IPP during peristalsis was higher in animal groups with ureteral stone, both in the solitary and bilateral systems (9–11 cm H2O), compared to those without ureteral stone (4cm H2O)(p<0.05). However,there was no significant difference in the IPP between the animals with ureteral stone in a solitary kidney compared to normal contralateral kidney. There was an initial decrease (first 2 hours) in the median arterial RI following nephrectomy (0.56) and also following stone placement (0.56) in pigs with normal contralateral kidney. However, there was no significant change in the RI following stone placement in a solitary kidney. CONCLUSIONS In the above acute porcine study, there was increase in peristalsis rate and median IPP in animals with ureteral stone. In animals with a solitary kidney and ureteral stone, there was no significant increase in IPP or peristalsis compared to those with ureteral stone and normal contralateral kidney. Contralateral nephrectomy or acute ureteral stone obstruction in a solitary/bilateral system showed insignificant acute biphasic changes in renal blood flow. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e767 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ramakrishna Venkatesh Lexington, KY More articles by this author Nitin Das St. Louis, MO More articles by this author Steven LaBarbera St. Louis, MO More articles by this author Geneva Baca St. Louis, MO More articles by this author Ahmed Tawfik St. Louis, MO More articles by this author Robert S. Figenshau St. Louis, MO More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...