Irrigation with isoproterenol during ureterorenoscopy causes no systemic side-effects

Abstract

Objective. Ureterorenoscopy causes complications that may be related to high intrarenal pressures generated during irrigation. Endoluminal isoproterenol administration has been shown to reduce pelvic pressure in pigs. The objective of this study was to investigate possible systemic side-effects of isoproterenol irrigation during ureterorenoscopy in humans. Material and methods. Seven patients undergoing ureterorenoscopy due to renal stone disease were included. A 5-Fr catheter was retrogradely placed in the renal pelvis for pressure measurements. Prior to irrigation with isoproterenol (0.1 µg/ml), ureterorenoscopy was performed with saline irrigation. Renal pelvic pressure, blood pressure and heart rate were measured before and after isoproterenol irrigation. Venous blood was drawn for isoproterenol measurements. Results. Endoluminal isoproterenol irrigation produced no changes in mean heart rate (HR) or mean arterial pressure (MAP). MAP (±SEM) was 56 (±2.7) mmHg during saline irrigation and 58 (±2.4) mmHg during isoproterenol irrigation. HR was 60 (±4) beats/min before and 61 (±4) beats/min during isoproterenol irrigation. Neither the difference in MAP (p = 0.10) nor the difference in HR (p = 0.23) were significant. Pelvic pressure was significantly lower during isoproterenol irrigation [19 (±3) mmHg] compared to saline irrigation [35 (±2.6) mmHg] (p = 0.0006). Pelvic pressure reached very high levels (>300 mmHg), especially during injection of contrast medium. Conclusions. Endoluminal isoproterenol irrigation during ureterorenoscopy causes no cardiovascular side-effects and the drug may reduce renal pelvic pressure.

• ureterorenoscopy
• endoluminal drug administration
• side-effects
• pelvic pressure
• isoproterenol