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Related Concept Videos

Introduction to Urinary System01:13

Introduction to Urinary System

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The urinary system consists of two kidneys, two ureters, the urinary bladder, and the urethra.
The kidneys are bean-shaped organs located in the retroperitoneal space, on either side of the vertebral column, between the T12 and L3 vertebrae. They are partially protected by the rib cage and surrounded by perirenal fat, which provides cushioning. They are responsible for urine formation and play critical roles in regulating blood pressure, electrolyte levels, and hormone production. The ureters...
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Intrarenal Pressure Monitoring During Ureteroscopy: A Delphi Panel Consensus.

Bhaskar Somani1, Niall Davis2, Esteban Emiliani3

  • 1Department of Urology University Hospital Southampton Southampton UK.

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Elevated intrarenal pressure (IRP) during ureteroscopy is a safety concern. Experts agree that high IRP is linked to patient complications, though a specific threshold remains undefined. Further research is needed to clarify these risks.

Keywords:
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Area of Science:

  • Urology
  • Nephrology
  • Surgical Procedures

Background:

  • Elevated intrarenal pressure (IRP) is a potential risk factor for complications during ureteroscopy (URS).
  • Current understanding of high IRP thresholds and associated patient risks is limited.
  • Expert consensus is needed to guide clinical management and research in this area.

Purpose of the Study:

  • To gather expert opinion on intrarenal pressure (IRP) during ureteroscopy (URS).
  • To define high IRP, identify associated complications, and determine patient risk factors.
  • To establish consensus on managing high IRP and understanding its clinical implications.

Main Methods:

  • Delphi methodology involving two online surveys and an in-person meeting.
  • A panel of 11 experienced European endourologists participated.
  • Consensus statements were developed and voted on to assess agreement levels.

Main Results:

  • Eleven consensus statements were achieved, covering high IRP definition, complications, and risk factors.
  • Moderate consensus was reached for nine statements, with strong consensus for two.
  • No specific IRP threshold was agreed upon, but pressures above 61-80 cm H2O raised safety concerns.

Conclusions:

  • Any intrarenal pressure (IRP) exceeding normal physiological levels is considered high.
  • High IRP during ureteroscopy poses a significant concern for patient safety.
  • Further research is crucial to elucidate the relationship between high IRP, patient characteristics, and clinical outcomes.