Carbon dioxide insufflation causes upper urinary tract injury in the early period of an experimental vesicoureteral reflux model
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Ureteral reimplantation via pneumovesicum is a new aspect of vesicoureteral reflux management. We aimed to determine the effects of carbon dioxide (CO2) insufflation on the upper urinary tract in an experimental model.
Materials and methods
Thirty New Zealand rabbits were allocated into five groups of six rabbits each. Right ureters were cannulated for CO2 insufflation in four groups. The pressures and durations of CO2 insufflation in the respective groups were as follows: Group A (10 mm Hg, 2 h); B (12 mm Hg, 2 h); C (10 mm Hg, 4 h); and D (12 mm Hg, 4 h) and control (E). Blood gas analysis, urea and creatinine levels were measured from renal veins and aorta. Histopathological evaluation of the renal parenchyma and ureters was scored.
Significant histopathological changes were detected in the ipsilateral ureter and renal parenchyma exposed to CO2 insufflation, predominantly observed in groups insufflated for longer durations, p < 0.05. Blood gases drawn separately from renal veins were significantly more acidotic, and serum urea and creatinine levels were increased in all the groups, p < 0.05.
CO2 causes significant histopathological and biochemical changes in the early period. Long-term results are required to determine whether permanent renal injury occurs.
KeywordsCarbon dioxide Upper urinary tract Vesicoureteral reflux Pneumovesicum Ureteral reimplantation
We thank Omer Uysal of the Bezmialem Vakif University Medical Faculty Department of Biostatics for the statistical analysis. We also thank Zafer Dogan for his contributions to this study.
Conflict of interest
The authors declare that they have no conflicts of interest.
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