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Continuous monitoring of intrapelvic pressure during flexible ureteroscopy using a sensor wire: a pilot study

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Abstract

Purpose

To evaluate the feasibility of measuring the intrapelvic pressure (IPP) during f-URS with a wire including a pressure sensor and to assess IPP profiles during the procedure.

Methods

Patients undergoing f-URS for stone disease were recruited. A wire with pressure sensor was placed in the renal cavities to measure IPP. For these cases, either no ureteral access sheath (UAS) or 10/12 or 12/14-Fr UASs were used according to surgeon discretion. Irrigation was ensured by a combination of a continuous pressure generator set at 80 cmH2O and a hand-assisted irrigation system providing on-demand forced irrigation to provide proper visibility. Pressures were monitored in real time and recorded for analysis.

Results

Four patients undergoing five f-URS were included. IPP monitoring was successful in all patients. Mean baseline IPP was 6 cmH2O. During f-URS with only the endoscope in the renal cavities and irrigation pressure set at 80 cmH2O without any forced irrigation, the mean IPP was 63 cmH2O. Mean IPP during laser lithotripsy with the use of on-demand forced irrigation was 115.3 cmH2O. The maximum pressure peaks recorded during this therapeutic period using forced irrigation ranged from 289.3 to 436.9 cmH2O.

Conclusion

High IPP levels may be achieved during f-URS with on-demand irrigation systems. The impact of these high pressures on the risk of complications and long-term consequences still need to be evaluated adequately. But, in this preliminary pilot study, IPP could be reliably and conveniently monitored and recorded using a wire with a digital pressure sensor.

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Authors and Affiliations

  1. Sorbonne Université, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, F-75020, Paris, France

    Steeve Doizi, Julien Letendre, Jonathan Cloutier, Achilles Ploumidis & Olivier Traxer

  2. Sorbonne Université, Service d’Urologie, AP-HP, Hôpital Tenon, F-75020, Paris, France

    Steeve Doizi, Julien Letendre, Jonathan Cloutier, Achilles Ploumidis & Olivier Traxer

  3. Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, Canada

    Julien Letendre

  4. Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Hôpital Saint-François D’Assise, 10 rue de l’Espinay, Ville de Québec, QC, G1L 3K5, Canada

    Jonathan Cloutier

  5. Department of Urology, Athens Medical Centre, Athens, Greece

    Achilles Ploumidis

Authors
  1. Steeve Doizi
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  2. Julien Letendre
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  3. Jonathan Cloutier
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  4. Achilles Ploumidis
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  5. Olivier Traxer
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Contributions

SD: protocol development, data collection and management, data analysis, manuscript writing/editing. JL: protocol development, data collection and management, data analysis, manuscript writing/editing. JC: data analysis, manuscript editing. AP: data analysis, manuscript editing. OT: project development, data analysis, manuscript editing.

Corresponding author

Correspondence to Steeve Doizi.

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Conflict of interest

Olivier Traxer is a consultant for: Boston Scientific, Coloplast, EMS, IPG Medical, Olympus, Rocamed. Steeve Doizi is a consultant for: Boston Scientific, Coloplast. Julien Letendre, Jonathan Cloutier, Achilles Ploumidis have no conflict of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (include name of committee + reference number) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Doizi, S., Letendre, J., Cloutier, J. et al. Continuous monitoring of intrapelvic pressure during flexible ureteroscopy using a sensor wire: a pilot study. World J Urol 39, 555–561 (2021). https://doi.org/10.1007/s00345-020-03216-w

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  • DOI: https://doi.org/10.1007/s00345-020-03216-w

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