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Fluid absorption during ureterorenoscopy.

Peter Cybulski1, R John D A Honey, Kenneth Pace

  • 1Division of Urology, St. Michael's Hospital, Toronto, Ontario, Canada.

Journal of Endourology
|January 22, 2005
PubMed
Summary

Routine ureterorenoscopy (URS) involves minimal systemic fluid absorption, even with ureteral perforations. This suggests sterile water irrigation is likely safe during URS procedures.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery

Background:

  • Ureterorenoscopy (URS) is a standard minimally invasive procedure for diagnosing and treating ureteral and renal conditions.
  • Systemic fluid absorption during URS has not been prospectively evaluated, despite potential for significant absorption in other endoscopic urologic procedures.

Purpose of the Study:

  • To prospectively assess systemic fluid absorption during routine ureterorenoscopy (URS).
  • To determine the safety of using irrigation fluids other than normal saline during URS.

Main Methods:

  • Volumetric balance was calculated by measuring all instilled and collected fluids during URS in 23 patients.
  • Urine output was estimated using creatinine concentration.
  • Systemic fluid absorption was assessed by measuring drainage fluid and changes in patient/drape weights.

Main Results:

  • The mean systemic fluid absorption during URS was 54 mL (range 4-137 mL).
  • Mean operative time was 55 minutes, with a mean URS time of 37 minutes.
  • Two intraoperative ureteral perforations occurred without postoperative complications.

Conclusions:

  • Routine URS is associated with minimal systemic fluid absorption, with potential discrepancies attributed to evaporative and unaccounted losses.
  • The study supports the safety of using sterile water for irrigation during URS, as significant fluid absorption is unlikely.

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