High pressure endoscopic irrigation: impact on renal histology

Purpose: High intra-renal pressures during flexible ureteroscopy have been associated with adverse renal tissue changes as well pyelovenous backflow. Our objective was to investigate the effect of various on histologic and fluid extravasation simulated ureteroscopy. Materials Methods: Twenty-four juvenile pig kidneys intact ureters were cannulated an Olympus ureteroscope without a ureteral access sheath subjected India ink-infused saline irrigation for 30 minutes at constant ranging from sphygmomanometer settings 50mm, 100mm 200mmHg. Renal samples collected, processed stained, evaluated by blinded pathologist depth ink penetration into parenchyma percentage total parenchymal thickness urothelium capsule. Results: The mean present in cortical tubules pressure 50, 100, 200mm Hg 33.1, 31.0 99.3%, respectively 0, 0 18.8%, respectively. Overall, demonstrated smaller among all compared (6.3% vs. 54.5%, p=0.0354). Of placement, 11% any 56% placement. Conclusions: Pressurized endoscopic leads significant parenchyma. Higher increased irrigant ex-vivo porcine model.