Experimental Study Of Indirect Control Of Intrapelvic Pressure During Flexible Ureteroscopy

Object：To investigate the relevant irrigation pressures the intrapelvic pressure(IPP) being40cmH2O during flexible ureteroscopy for porcines.Methord:40kidneys were exposedimmediately,randomle divided into4groups,after20pigs were killed.Ureter sheaths were firstretrograde inserted into lower or middle ureter,retrograde ureteroscopy was performed in the first3groups.In the4thgroup, ureter,retrograde ureteroscopy was performed not using ureter sheath.40kidneys performed renopunture with18G puncture needle.Puncture needle was connected withpressure sensors.Different irrigation pressure generated from suspension of saline of3L bag, wasmonitored.The relevant irrigation pressure were recordec intrarenal pressure being10cmH2O、20cmH2O、30cmH2O、40cmH2O and50cmH2O.Result:IPP10cmH2O and ureter sheath insertedinto middle ureter,the relevant irrigation pressure of F7、F8、F9ureteroscope was29.70±0.949、27.50±2.068、24.10±1.792cmH2O,but not using ureter sheath, the relevant irrigationpressure of F8ureterodcope was10.10±1.853cmH2O；IPP20cmH2O and ureter sheath insertedinto middle ureter,the relevant irrigation pressure of F7、F8、F9ureteroscope was41.70±1.160、39.70±2.003、36.202±.004cmH2O,but not using ureter sheath, the relevant irrigationpressure of F8ureterodcope was22.10±1.853；IPP30cmH2O and ureter sheath inserted intomiddle ureter,the relevant irrigation pressure of F7、F8、F9ureteroscope was53.80±1.229、51.90±1.663、48.30±1.947cmH2O,but not using ureter sheath, the relevant irrigation pressureof F8ureterodcope was34.10±1.853cmH2O；IPP40cmH2O and ureter sheath inserted intomiddle ureter,the relevant irrigation pressure of F7、F8、F9ureteroscope was66.10±1.197、64.20±1.398、60.60±2.066cmH2O,but not using ureter sheath, the relevant irrigation pressureof F8ureterodcope was46.40±1.776cmH2O.Conclusion:IPP rise gradually,with the increase ofirrigation pressure during flexible ureteroscopy for porcines.IPP40cmH2O,irrigation pressure isconnected with diameter of flexible ureteroscope、 ureter sheath and it’s location.IPP40cmH2O,F14/12ureter sheath inserted into middle ureter,F7flexible ureteroscope can provide themost effective water channel.