Acute renal insufficiency following hydrostatic pressure treatment: comments on technical procedure

A man with a solitary bladder carcinoma suffered acute tubular necrosis following hydrostatic pressure therapy. The nephrotoxicity caused by antibiotics and/or the septicemic shock seems to be responsible. The animal experiment suggested changes in the technique: 1) the bladder should be overdistended via a Foley catheter with a rubber ballon at the tip to prevent a possible postoperative complication and 2) one should try to decrease rather than maintain the high intravesical pressure during overdistension to avoid bladder wall rupture. The overstretching of a blood vessel alone is quite sufficient to bring the anoxia upon the bladder tumor, which is verfied by the biophysical principle.