(1) Introduction: To evaluate the feasibility of measuring the intrapelvic pressure (IPP) during flexible ureterorenoscopy (f-URS) with a PressureWire and to optimize safety by assessing IPP during surgery. (2) Methods: Patients undergoing f-URS for different treatments were recruited. A PressureWire (0.014", St. Jude Medical, Little Canada, MN, USA) was placed into the renal cavities to measure IPP. Gravity irrigation at 40 cmH2O over the patient and a hand-assisted irrigation system were used. Pressures were monitored in real time and recorded for analysis. Fluid balance and postoperative urinary tract infection (UTI) were documented. (3) Results: Twenty patients undergoing f-URS were included with successful IPP monitoring. The median baseline IPP was 13.6 (6.8-47.6) cmH2O. After the placement of the UAS, the median IPP was 17 (8-44.6) cmH2O. With irrigation pressure set at 40 cmH2O without forced irrigation, the median IPP was 34 (19-81.6) cmH2O. Median IPP during laser lithotripsy, with and without the use of on-demand forced irrigation, was 61.2 (27.2-149.5) cmH2O. The maximum pressure peaks recorded during forced irrigation ranged from 54.4 to 236.6 cmH2O. After the surgery, 3 patients (15%) presented UTI; 2 of them had a positive preoperative urine culture, previously treated, and a positive fluid balance observed after the surgery. (4) Conclusion: Based on our experience, continuous monitoring of IPP with a wire is easy to reproduce, effective, and safe. In addition, it allows us to identify and avoid high IPPs, which may affect surgery-related complications.
Journal of clinical medicine. 2022 Dec 24*** epublish ***
Alba Sierra, Mariela Corrales, Merkourios Kolvatzis, Steeve Doizi, Olivier Traxer
Urology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Villarroel 170, 08036 Barcelona, Spain., Sorbonne University GRC Urolithiasis No. 20 Tenon Hospital, F-75020 Paris, France.