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Risks of flexible ureterorenoscopy: pathophysiology and prevention
1Urological Research Center, Department of Urology, Lillebaelt Hospital, Beridderbakken 4, 7100, Vejle, Denmark. palle.joern.osther@rsyd.dk.
Urolithiasis
|November 20, 2017
Summary
Flexible ureterorenoscopy (fURS) is increasingly used, but complications like sepsis can arise from altered upper urinary tract physiology. Understanding these pathophysiological changes is key to minimizing risks during fURS procedures.
Area of Science:
- Urology
- Medical Technology
Background:
- Flexible ureterorenoscopy (fURS) indications are expanding due to technological progress.
- While generally safe, fURS can lead to serious complications like sepsis and ureteral lesions.
Purpose of the Study:
- To explore the pathophysiological mechanisms behind fURS complications.
- To provide a basis for preventive strategies by understanding ureteral access and pressure changes.
Main Methods:
- Review of pathophysiological processes related to fURS.
- Analysis of factors influencing intrarenal pressure and pyeloureteral dynamics.
- Examination of preventive measures from a pathophysiological viewpoint.
Main Results:
- fURS complications stem from ureteral access and irrigation, disrupting normal physiology.
- Pathophysiological changes include intrarenal/pyelovenous backflow and ureteral contractions.
- Knowledge of physiology is crucial for mitigating fURS-related harm.
Conclusions:
- Understanding the pathophysiology of intrarenal pressure and ureteral access is vital for fURS safety.
- Preventive measures such as antibiotics, ureteral access sheaths, and pharmacologic modulation are reviewed.
- Minimizing fURS complications requires a deep understanding of upper urinary tract physiology.
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