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Role of Intrarenal Pressure in Modern Day Endourology (Mini-PCNL and Flexible URS): a Systematic Review of Literature

Current Urology Reports volume 22, Article number: 52 (2021) Cite this article

Abstract

Purpose of Review

To review the latest evidence about intrarenal pressures (IRPs) generated during flexible ureteroscopy (fURS) and mini percutaneous nephrolithotomy (mPCNL) and present tools and techniques to maintain decreased values.

Recent Finding

fURS and PCNL constitute the primary means of stone treatment. New flexible ureterorenoscopes with small diameter and miniaturized PCNL instruments achieve optimal stone-free rates (SFRs) while decreasing invasiveness and morbidity. Nevertheless, endourologists must remain cognizant regarding the dangers of increased IRPs to avoid complications. Current research presents essential information for urologists regarding this topic.

Summary

During fURS, using a ureteral access sheath (UAS), we avoid extremely high IRPs with all irrigation types. During mPCNL, pressure remains low, mainly using the purging effect or a vacuum-assisted sheath. Devices of intraoperative IRP measurement and intelligent pressure control have proven their feasibility, accuracy and efficacy. These will have an increasing role to play in the future management of stone disease.

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Author information

Authors and Affiliations

  1. Department of Urology and Andrology, General Hospital Hall I.T, Milser Str. 10, 6060, Hall i.T., Hall in Tirol, Austria

    Theodoros Tokas & Udo Nagele

  2. Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria

    Theodoros Tokas & Udo Nagele

  3. Medical School, University of Pavia, Harvey Course, Pavia, Italy

    Eirini Tzanaki

  4. Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK

    Bhaskar Kumar Somani

  5. Department of Urology, Manipal Academy of Higher Education (MAHE), Manipal, India

    Bhaskar Kumar Somani

Authors
  1. Theodoros Tokas
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  2. Eirini Tzanaki
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  3. Udo Nagele
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  4. Bhaskar Kumar Somani
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Contributions

T Tokas: Data management, data analysis, manuscript writing. E. Tzanaki: Data management, interpreting data. U Nagele: Interpreting data. B K Somani: Protocol/project development and interpreting data.

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Correspondence to Theodoros Tokas.

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This review does not involve human participants and/or animals.

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Tokas, T., Tzanaki, E., Nagele, U. et al. Role of Intrarenal Pressure in Modern Day Endourology (Mini-PCNL and Flexible URS): a Systematic Review of Literature. Curr Urol Rep 22, 52 (2021). https://doi.org/10.1007/s11934-021-01067-5

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  • DOI: https://doi.org/10.1007/s11934-021-01067-5

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