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Intra-renal Pressure

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Percutaneous Renal Surgery

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Abstract

Pressure generation via instillation of irrigation during percutaneous nephrolithotomy is necessary for procedural safety and efficacy; termed intra-renal pressure (IRP). As iatrogenic pressures rise above physiologic levels intra-renal reflux, or fluid transposition outside of the collecting system, can occur. This shift of fluid and endotoxins, if present, has implications on post-operative pain/recovery, infectious and inflammatory responses, and systemic fluid/electrolyte imbalances. Numerous ex vivo human and in vivo animal studies have evaluated pressure thresholds for the three subtypes of intrarenal reflux: pyelovenous backflow, pyelosinuous backflow and intra-renal backflow. Knowledge and mitigation of procedural factors that lead to pressure rise during PCNL allows Urologists to minimize complications associated with elevated IRP.

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Acknowledgements

Appreciation to Pradeep Sharma for his assistance in medical illustration for this chapter.

PressureWire is a trademark of Abbott or its related companies. Reproduced with permission of Abbott, © 2023. All rights reserved.

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Authors and Affiliations

  1. Department of Urology, The Ohio State University Medical Center, 915 Olentangy River Road, Suite 3100, Columbus, OH, 43215, USA

    Eric Riedinger & Bodo Knudsen

  2. Department of Urology, University of Southern Denmark, Vejle, Denmark

    Palle Jörn Sloth Osther

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  1. Eric Riedinger
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  2. Palle Jörn Sloth Osther
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  3. Bodo Knudsen
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Correspondence to Eric Riedinger .

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Editors and Affiliations

  1. Western University, London, ON, Canada

    John D. Denstedt

  2. University Hospital of Patras, Patras, Greece

    Evangelos N. Liatsikos

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Riedinger, E., Osther, P.J.S., Knudsen, B. (2023). Intra-renal Pressure. In: Denstedt, J.D., Liatsikos, E.N. (eds) Percutaneous Renal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-40542-6_29

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  • DOI: https://doi.org/10.1007/978-3-031-40542-6_29

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