Fluid-electrolyte and renal pelvic pressure changes during ureteroscopic lithotripsy

Abstract

The objective of the study was to evaluate fluid-electrolyte and renal pelvic pressure (RPP) changes during ureteroscopic lithotripsy. Fifteen patients were detected with residual ureteral calculi after minimally invasive percutaneous nephrolithotomy (MPCNL), distal ureter calculi in three, midureter calculi in four, proximal calculi in eight. RPP was measured via the percutaneous nephrostomy tube by urodynamic study at irrigation pressures of 50, 100 and 200 mmHg. Haemoglobin (Hb), haematocrit (Hct), blood urea mitrogen (BUN), creatinine (Cre), serum sodium (Na⁺), potassium (K⁺), chlorine (Cl^-) were recorded before and after ureteroscopic lithotripsy. There were no significant differences between Hb, Hct, BUN, Cre, Na⁺, K⁺, Cl^- values. Baseline RPP was (16.37 ± 3.14) cmH₂O, RPPs were 46.06 ± 6.85 cmH₂O, 99.07 ± 14.62 cmH₂O and 166.27 ± 33.08 cmH₂O at irrigation pressures of 50, 100 and 200 mmHg, they were much higher than baseline RPP (p < 0.0001). RPP in the proximal ureter was much higher than in the distal and middle ureter, 50.98 ± 4.52 cmH₂O versus 40.44 ± 4.07 cmH₂O (p = 0.0004), 110.26 ± 2.39 cmH₂O versus 86.29 ± 11.60 cmH₂O (p = 0.0014), 193.21 ± 5.88 cmH₂O versus 135.47 ± 20.95 cmH₂O (p = 0.0002) at irrigation pressures of 50, 100 and 200 mmHg. There were no significant changes in fluid-electrolyte. RPP was significantly increased during ureteroscopic lithotripsy, it was correlated with the irrigation pressure and the position in the ureter.

Key words::

• Fluid-electrolyte
• renal pelvic pressure
• ureteroscopic lithotripsy

Acknowledgements

This study was funded by Shanghai health bureau (2007Y21).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.