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Fluid absorption during flexible ureteroscopy with intelligent control of renal pelvic pressure: a randomized controlled trial

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Abstract

Purpose

To investigate fluid absorption and its influencing factors during flexible ureteroscopy with intelligent control of renal pelvic pressure (RPP).

Methods

A total of 80 patients with upper urinary tract calculi underwent flexible ureteroscopy with intelligent control of RPP by pressure-measuring ureteral access sheath and were randomly divided into four groups. The RPP of Groups A, B, and C were set at – 5, 0 and 5 mmHg, respectively. Conventional flexible ureteroscopy with uncontrolled pressure served as control Group D. The perfusion flow rate was set at 100 ml/min in the four groups, with 20 patients in each group. The fluid absorption was measured by 1% ethanol every 10 min. Operation time, stone-free rate, and complications were recorded.

Result

Seventy-three patients were finally included in the RCT. The general and preoperative data of the patients were comparable between the groups. The fluid absorption of Groups A, B, and C was significantly less than that of Group D (P < 0.01). Fluid absorption and operation time were positively correlated, and the correlation coefficients R were 0.864, 0.896, 0.918, and 0.947, respectively (P < 0.01). The fluid absorption of patients with vomiting, fever and ureteral injury was greater than that of patients without complications in the four groups (P < 0.01). In different groups, fluid absorption was greater in patients with ureteral injury Post-Ureteroscopic Lesion Scale (PULS) 1–3 than in noninjured patients (P < 0.01).

Conclusion

Flexible ureteroscopy with intelligent control of RPP effectively reduces the absorption of perfusion fluid. Operation time and ureteral injury are also key factors affecting perfusion fluid absorption.

Registration number and date

NCT05201599; August 11, 2021.

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Data availability

The authors confirm that the data supporting the findings of this study are available within the article.

Abbreviations

RPP :

Renal pelvic pressure (RPP)

RCT:

Randomized controlled trial

FURS-ICP:

Flexible ureteroscopy with intelligent control of RPP

PULS:

Post-Ureteroscopic Lesion Scale

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Funding

This work was supported by the Ganzhou Science and Technology Innovation Talent Plan of 2019 and Ganjiang Scholars Program of Ganzhou People's Hospital (2021–121). Jiangxi Provincial Science and Technology Agency, 20202BBGL73089.

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Author notes

  1. Xiaolin Deng and Yijian Chen have contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, 17 Hongqi Avenue, Ganzhou City, 341000, Jiangxi Province, People’s Republic of China

    Xiaolin Deng, Yijian Chen, Qiliang Zhai, Leming Song & Chuance Du

  2. Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China

    Wanlong Tan

  3. Jiangxi Inventor Technology Company Limited, Jiangxi, China

    Xiaolin Deng & Leming Song

Authors
  1. Xiaolin Deng
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  2. Yijian Chen
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  3. Qiliang Zhai
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  4. Leming Song
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  5. Chuance Du
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  6. Wanlong Tan
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Contributions

RCT design: XD and WT; Surgeons: XD and LS; Acquisition of data: YC and CD; Analysis and interpretation of data: YC, CD; Drafting of the manuscript and statistical analysis: XD,QZ; Critical revision: CD and WT. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Wanlong Tan.

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Conflict of interest

The author declares that they have no conflicts of interest.

Ethical approval

The research of the RCT was reviewed and approved by the hospital ethics committee. The RCT was registered in ClinicalTrials.gov with a registration number of NCT05201599. The study was performed in accordance with the ethical standards as laid down in the 2013 Declaration of Helsinki.

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Deng, X., Chen, Y., Zhai, Q. et al. Fluid absorption during flexible ureteroscopy with intelligent control of renal pelvic pressure: a randomized controlled trial. World J Urol 42, 331 (2024). https://doi.org/10.1007/s00345-024-05036-8

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  • DOI: https://doi.org/10.1007/s00345-024-05036-8

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