Novel non-invasive intrarenal pressure monitoring devices in flexible ureteroscopy: an in-vitro comparative study

Intrarenal pressure monitoring is emerging as an important tool in flexible ureteroscopy. Novel non-invasive intrarenal pressure monitoring devices are introduced. We evaluated the pressure readings simultaneously across four novel non-invasive intrarenal pressure monitoring devices against the urodynamic system.

Two IRP monitoring single-use flexible ureteroscopy: LithoVue Elite^™ (Boston Scientific Corporation, Marlborough, MA, USA); ZebraScope^™ (Happiness Works Medical Instruments Co., Ltd, Anhui, China); two intelligent intrarenal system integrated with irrigation and suction via flexible and navigable suction ureteral access sheath: i-MIMERsys^™ (ZSR Biomedical Technology Co., Ltd, Dongguan, China); Tidor^™ (YiGao Medical Technology Co., Ltd, Zhejiang, China) were tested against MMS/Laborie Nexam Pro Urodynamic System (Laborie Medical Technologies Corporation, Portsmouth, USA).

The degree of agreement between measurements from urodynamic system and the experimented device was demonstrated by Bland-Altman plots and intraclass correlation coefficients (ICCs). Compared to the urodynamic system, the average difference ± standard deviation of LithoVue Elite™ was 0.26 ± 1.75mmHg; ZebraScope™ 3.22 ± 1.86mHg, i-MIMERsys™ 0.96 ± 2.26mmhg; Tidor™ 1.09 ± 2.57mmHg. Pressure measured by LithoVue Elite™, ZebraScope™, i-MIMERsys™ and Tidor™ to urodynamic system showed excellent ICCs of 0.975 (p < 0.001), 0.915(p = 0.016), 0.955(p < 0.001) and 0.937(p < 0.001) respectively.

Pressure recordings from four novel non-invasive intrarenal monitoring devices, namely flexible ureteroscopes-LithoVue Elite^™, ZebraScope^™; and intelligent IRP monitoring systems via flexible and navigable suction ureteral access sheaths - i-MIMERsys^™, Tidor^™. were comparable to that of urodynamic system. This in-vitro study verifies that such non-invasive devices provide reliable data for monitoring intrarenal pressure changes.