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Jens Christian Djurhuus - One of the best experts on this subject based on the ideXlab platform.

  • Renal water and sodium handling during gradated unilateral ureter obstruction.
    Scandinavian Journal of Urology and Nephrology, 2009
    Co-Authors: T. S. Pedersen, Jens Christian Djurhuus, Jørgen Frøkiær
    Abstract:

    Objective: Unilateral complete obstruction of the ureter (UUO) is associated with characteristic changes in renal function. To improve the understanding of how urine concentration directly is affected by changes in Pelvic Pressure, changes in renal salt and water handling along the nephron and collecting duct were examined. Material and Methods: Pelvic Pressure was raised stepwise using an adjustable lever inserted in the right ureter. Urine samples were collected from the tip of the catheter by way of an overflow system. Water and sodium handling in the distal and proximal tubules were measured by the lithium clearance technique. Renal blood flow (RBF) was measured with implanted ultrasonic flow probes. Catheters were placed in both renal veins and glomerular filtration rate (GFR) and filtration fraction were calculated using renal extraction of 51 Cr-EDTA independent of urine sampling. Results: The sequence of changes for each parameter is provided. The parameters did not show a uniform pattern from whi...

  • Irrigation with isoproterenol diminishes increases in Pelvic Pressure without side-effects during ureterorenoscopy: a randomized controlled study in a porcine model.
    Scandinavian journal of urology and nephrology, 2007
    Co-Authors: Hu Jung, Jens Mortensen, Js Jakobsen, Palle Jørn Sloth Osther, Jens Christian Djurhuus
    Abstract:

    Objective. Recently, we showed that endoluminally administered isoproterenol (ISO) inhibits muscle function of the pyeloureter in swine. This may be of value in managing increases in Pelvic Pressure during upper urinary tract endoscopy. The purpose of this study was to examine the effect of endoluminally administered ISO on increases in Pelvic Pressure and cardiovascular function during flexible ureterorenoscopy. Material and methods. The study was performed in anaesthetized female pigs. In terms of endoscopic procedures, the pigs were randomized as follows: Group 1, irrigation with 0.1 µg/ml ISO added to saline (n=12); and Group 2, irrigation with saline (n=10). A 5-Fr catheter was retrogradely placed in the renal pelvis and an 8-Fr catheter in the bladder for Pressure measurements. Flexible ureterorenoscopy was performed with constant irrigation at a perfusion rate of 8 ml/min. Pelvic, bladder and blood Pressure and heart rate were registered continuously. Results. Mean baseline Pelvic Pressure was iden...

  • cyclooxygenase type 2 is increased in obstructed rat and human ureter and contributes to Pelvic Pressure increase after obstruction
    Kidney International, 2006
    Co-Authors: Rikke Norregaard, Jens Christian Djurhuus, Boye L Jensen, Sukru Oguzkan Topcu, S S Nielsen, S Walter, Jørgen Frøkiær
    Abstract:

    Prostanoids exert physiological effects on ureteral contractility that may lead to Pressure changes and pain during obstruction. In the present study, we examined whether (1) obstruction changes the expression of the two cyclooxygenase (COX) isoforms, COX-1 and COX-2 in human and rat ureters and (2) administration of a selective COX-2 inhibitor influences the Pelvic Pressure change after experimental ureteral obstruction. Rats were subjected to bilateral ureter obstruction. Ureters were removed and dissected into a proximal dilated and distal non-dilated segment. RNA and protein were extracted and analyzed for cyclooxygenase expression by quantitative polymerase chain reaction and Western blotting. Human ureter samples were obtained from patients undergoing radical nephrectomy. Rat and human ureteral samples were processed for immunohistochemistry. COX-1, but not COX-2 mRNA, was readily detected in the normal rat ureter. COX-2 mRNA and protein expression was increased in the proximal dilated ureter compared to distal non-dilated ureter. This increased COX-2 expression was associated with increased urinary prostaglandin E2 (PGE2) excretion after release of obstruction. Immunohistochemistry showed increased COX-2 labeling in surface epithelium and smooth muscle layers in both rat and human obstructed ureters compared to control ureters. Furthermore, contractile PGE2-EP1 and thromboxane TP receptors were expressed in ureteral smooth muscle. Systemic treatment with the COX-2 selective inhibitor parecoxib (5 mg/kg/day) attenuated the Pelvic Pressure increase during obstruction. In summary, COX-2 expression is significantly increased in the ureteral wall in response to obstruction in the rat and human ureter and COX-2 activity contributes to increased Pelvic Pressure after obstruction.

  • Endoluminal Pelvic perfusion with norepinephrine causes only minor systemic effects and diminishes the increase in Pelvic Pressure caused by perfusion.
    Scandinavian journal of urology and nephrology, 2005
    Co-Authors: Uffe Holst, Jens Christian Djurhuus, Yazan F. Rawashdeh, Frederik Andreasen, Jens Mortensen
    Abstract:

    Objective. To evaluate the effect of endoluminal norepinephrine (NE) on transport Pressures of the normal upper urinary tract of the pig and on plasma levels of NE in relation to possible systemic effects. Material and methods. Six anaesthetized pigs weighing ≈39 kg were studied. Transparenchymally, two 6-F catheters were introduced into the renal pelvis bilaterally to measure Pressure and perfusion. Ultrasonic flow probes recorded renal arterial blood flow, and a transurethral 10-F catheter drained the bladder and monitored diuresis. In all six animals, the bilateral Pelvic Pressure response was examined at increasing perfusion rates (2, 4, 6, 8, 10 and 15 ml/min) and with increasing doses of NE (0, 5, 50 and 100 µg/ml). Arterial blood samples were analysed for NE, epinephrine and blood glucose. The systemic blood Pressure, heart rate and electrocardiogram were registered. Results. At all the investigated concentrations, endoluminal NE significantly diminished the increase in Pelvic Pressure caused by pe...

  • NOREPINEPHRINE INHIBITS THE Pelvic Pressure INCREASE IN RESPONSE TO FLOW PERFUSION
    The Journal of urology, 2003
    Co-Authors: U. Holst, Jørgen Frøkiær, Jens Christian Djurhuus, Yazan F. Rawashdeh, Thomas H. Dissing, Jens Mortensen
    Abstract:

    ABSTRACTPurpose: We evaluated the effects of norepinephrine on transport Pressures in the normal upper urinary tract of the pig during increasing perfusion rates.Materials and Methods: Anesthetized Danish landrace Yorkshire pigs weighing 38 to 40 kg were studied. Transparenchymally 2, 6Fr catheters were introduced into the left renal pelvis for Pressure measurements and perfusion, respectively. An ultrasonic flow probe was inserted around the left renal artery to record blood flow. A 10Fr catheter was placed transurethrally for bladder drainage and the bladder was maintained empty during the entire study. In the 5 group 1 pigs the Pelvic Pressure increase was examined at increasing perfusion rates of the renal pelvis (2, 4, 6, 8, 10 and 15 ml per minute) in response to endoluminal administration of increasing concentrations of norepinephrine (0, 5, 50 and 100 μg/ml) in saline. In the 5 group 2 pigs the Pressure flow study was also done 4 times per animal using isotonic saline.Results: Endoluminal norepine...

Jørgen Frøkiær - One of the best experts on this subject based on the ideXlab platform.

  • Renal water and sodium handling during gradated unilateral ureter obstruction.
    Scandinavian Journal of Urology and Nephrology, 2009
    Co-Authors: T. S. Pedersen, Jens Christian Djurhuus, Jørgen Frøkiær
    Abstract:

    Objective: Unilateral complete obstruction of the ureter (UUO) is associated with characteristic changes in renal function. To improve the understanding of how urine concentration directly is affected by changes in Pelvic Pressure, changes in renal salt and water handling along the nephron and collecting duct were examined. Material and Methods: Pelvic Pressure was raised stepwise using an adjustable lever inserted in the right ureter. Urine samples were collected from the tip of the catheter by way of an overflow system. Water and sodium handling in the distal and proximal tubules were measured by the lithium clearance technique. Renal blood flow (RBF) was measured with implanted ultrasonic flow probes. Catheters were placed in both renal veins and glomerular filtration rate (GFR) and filtration fraction were calculated using renal extraction of 51 Cr-EDTA independent of urine sampling. Results: The sequence of changes for each parameter is provided. The parameters did not show a uniform pattern from whi...

  • cyclooxygenase type 2 is increased in obstructed rat and human ureter and contributes to Pelvic Pressure increase after obstruction
    Kidney International, 2006
    Co-Authors: Rikke Norregaard, Jens Christian Djurhuus, Boye L Jensen, Sukru Oguzkan Topcu, S S Nielsen, S Walter, Jørgen Frøkiær
    Abstract:

    Prostanoids exert physiological effects on ureteral contractility that may lead to Pressure changes and pain during obstruction. In the present study, we examined whether (1) obstruction changes the expression of the two cyclooxygenase (COX) isoforms, COX-1 and COX-2 in human and rat ureters and (2) administration of a selective COX-2 inhibitor influences the Pelvic Pressure change after experimental ureteral obstruction. Rats were subjected to bilateral ureter obstruction. Ureters were removed and dissected into a proximal dilated and distal non-dilated segment. RNA and protein were extracted and analyzed for cyclooxygenase expression by quantitative polymerase chain reaction and Western blotting. Human ureter samples were obtained from patients undergoing radical nephrectomy. Rat and human ureteral samples were processed for immunohistochemistry. COX-1, but not COX-2 mRNA, was readily detected in the normal rat ureter. COX-2 mRNA and protein expression was increased in the proximal dilated ureter compared to distal non-dilated ureter. This increased COX-2 expression was associated with increased urinary prostaglandin E2 (PGE2) excretion after release of obstruction. Immunohistochemistry showed increased COX-2 labeling in surface epithelium and smooth muscle layers in both rat and human obstructed ureters compared to control ureters. Furthermore, contractile PGE2-EP1 and thromboxane TP receptors were expressed in ureteral smooth muscle. Systemic treatment with the COX-2 selective inhibitor parecoxib (5 mg/kg/day) attenuated the Pelvic Pressure increase during obstruction. In summary, COX-2 expression is significantly increased in the ureteral wall in response to obstruction in the rat and human ureter and COX-2 activity contributes to increased Pelvic Pressure after obstruction.

  • NOREPINEPHRINE INHIBITS THE Pelvic Pressure INCREASE IN RESPONSE TO FLOW PERFUSION
    The Journal of urology, 2003
    Co-Authors: U. Holst, Jørgen Frøkiær, Jens Christian Djurhuus, Yazan F. Rawashdeh, Thomas H. Dissing, Jens Mortensen
    Abstract:

    ABSTRACTPurpose: We evaluated the effects of norepinephrine on transport Pressures in the normal upper urinary tract of the pig during increasing perfusion rates.Materials and Methods: Anesthetized Danish landrace Yorkshire pigs weighing 38 to 40 kg were studied. Transparenchymally 2, 6Fr catheters were introduced into the left renal pelvis for Pressure measurements and perfusion, respectively. An ultrasonic flow probe was inserted around the left renal artery to record blood flow. A 10Fr catheter was placed transurethrally for bladder drainage and the bladder was maintained empty during the entire study. In the 5 group 1 pigs the Pelvic Pressure increase was examined at increasing perfusion rates of the renal pelvis (2, 4, 6, 8, 10 and 15 ml per minute) in response to endoluminal administration of increasing concentrations of norepinephrine (0, 5, 50 and 100 μg/ml) in saline. In the 5 group 2 pigs the Pressure flow study was also done 4 times per animal using isotonic saline.Results: Endoluminal norepine...

  • Contralateral response in renal Pelvic Pressure and diuresis during increasing ipsilateral Pelvic Pressure and flow: a study of the normal and denervated upper urinary tract in pigs.
    BJU international, 2002
    Co-Authors: U. Holst, Jørgen Frøkiær, Jens Christian Djurhuus, G. Tuckus, Jens Mortensen
    Abstract:

    Objective  To examine, in young pigs, changes in baseline Pelvic Pressure and diuresis in the contralateral kidney during conditions of increasing Pelvic Pressure and perfusion with isotonic saline in the ipsilateral renal pelvis; the role of a reno-renal nervous mechanism was examined by denervating the kidneys, and the effect of bladder filling on these variables assessed. Materials and methods  Female pigs (37–40 kg) were assessed under general anaesthesia. Transparenchymally, one 6 F and two 6 F catheters were introduced into the right and left renal pelvis, respectively. Through a bladder incision an 8 F catheter was introduced 10 cm into the right ureter to collect urine and the orifice closed around the catheter. For bladder drainage and to measure bladder Pressure a 10 F catheter was placed in the bladder and both the 8 F and 10 F catheters lead out through the urethra. In group A, five animals served as controls, with group B comprising eight with intact nerves and group C eight with denervated kidneys. In group B and C the left renal pelvis was perfused with isotonic saline at 2, 4, 6, 8, 10, 12 and 16 mL/min while the bilateral Pelvic Pressure and right renal diuresis were recorded; the bladder was kept empty and 0.5 h later the left pelvis was perfused with 10 mL/min while the bladder catheter was closed. Perfusion continued until micturition occurred. The bilateral Pelvic Pressure, bladder Pressure and right renal diuresis were recorded. In group C the kidneys were surgically denervated, dividing all adhesions and all connective tissue around the pelvis and the vascular pedicle. The renal artery was freed to the aortic level. Results  During the Pressure-perfusion study the mean (sd) right Pelvic Pressure was 7.4 (0.2) mmHg in group B and 8.6 (0.2) mmHg in group C. The diuresis from the right kidney in both groups was similar and the same as that in group A. The perfusion rate and Pressure on the left side had no influence on Pelvic Pressure and diuresis on the right side. During perfusion with a full bladder the right Pelvic Pressure was 8.6 mmHg in group B and 9.5 mmHg in group C. Diuresis in group B was ≈ 0.6 mL/min and a little higher in group C, at ≈ 1 mL/min, but identical to that in group A. Conclusion  These results indicate that a reno-renal reflex mechanism has no apparent role in young pigs during Pressure-perfusion measurements with an empty or full bladder.

  • EXPERIMENTAL PARTIAL UNILATERAL URETER OBSTRUCTION. I. Pressure FLOW RELATIONSHIP IN A RAT MODEL WITH MILD AND SEVERE ACUTE URETER OBSTRUCTION
    The Journal of Urology, 1998
    Co-Authors: Jianguo Wen, Yue Chen, Jørgen Frøkiær, Troels Munch Jørgensen, Jens Christian Djurhuus
    Abstract:

    AbstractPurpose: To create an animal model with mild and severe partial unilateral ureter obstruction in young rats using a modified Ulm and Miller technique and to characterize the model by acute renal Pelvic Pressure measurements.Material and Methods: During anesthesia the upper fourth (n = 15) or the upper two-thirds of the left ureter (n = 15) was embedded into the psoas muscle causing either a mild or severe partial obstruction. Sham-operated control rats were prepared in paralllel (n = 20). The baseline Pelvic Pressure, the perfusion Pelvic Pressure (perfusion rates: 0.2 to 1.0 ml. per minute) and peristaltic waves were recorded after a resting period.Results: Mean baseline Pelvic Pressure and perfusion Pelvic Pressure were significantly higher in obstructed kidneys than in non-obstructed kidneys, and significantly higher in severely obstructed kidneys than in mildly obstructed kidneys (p

Xiaolin Deng - One of the best experts on this subject based on the ideXlab platform.

  • A Novel Technique to Intelligently Monitor and Control Renal Pelvic Pressure during Minimally Invasive Percutaneous Nephrolithotomy.
    Urologia internationalis, 2019
    Co-Authors: Xiaolin Deng, Leming Song, Jianrong Huang, Donghua Xie, Wanlong Tan
    Abstract:

    Objective To introduce a novel technique for intelligently monitoring and controlling renal Pelvic Pressure (RPP) in minimally invasive percutaneous nephrolithotomy (MPCNL) and to investigate its reliability and stability. Materials and methods A total of 63 kidney stone patients (41 males and 22 females) were enrolled in the study. The average stone size was 3.7 ± 1.1 cm. The average age was 41.6 ± 15.6 years old. All patients underwent MPCNL under combined spinal and epidural anesthesia in prone position. A ureteral catheter connected to an invasive blood Pressure monitor was retrogradely placed to measure renal Pelvic outlet Pressure. The MPCNL was performed with the aid of the patented device, including an irrigation and suctioning platform and a Pressure-measuring suctioning sheath. On the platform, the RPP control value was set at -5 mm Hg, and the RPP warning value was set at 20 mm Hg. RPP was measured during the irrigation and suctioning period (ISP), and therapeutic period (TP) when the infusion flow was set at 300, 400, and 500 mL/min, respectively, for 5 min. Results Sixty-three patients successfully underwent the procedure without serious complications. The mean operative time was 67 min (range 31-127 min). Three patients had residual stones >2 mm in size. No statistical significance was observed between the renal Pelvic outlet Pressure, platform RPP values, and RPP control values for the 300, 400, and 500 mL/min groups during the ISP and TP (p > 0.05). Conclusion The patented devices including the platform and the sheath can reliably and stably monitor and control RPP in real time and within a safe range during MPCNL.

  • suctioning flexible ureteroscopic lithotripsy in the oblique supine lithotomy position and supine lithotomy position a comparative retrospective study
    The Italian journal of urology and nephrology, 2018
    Co-Authors: Guanghua Peng, Leming Song, Jianrong Huang, Yuming Zhong, Xiaolin Deng
    Abstract:

    BACKGROUND: Flexible ureteroscopy is very valuable for treating upper urinary tract calculi. However, no report has yet compared the clinical outcomes of flexible ureteroscopy performed on patients in different body positions. Therefore, we compared the safety and efficacy of suctioning flexible ureteroscopic lithotripsy with automatic control of renal Pelvic Pressure in the oblique supine lithotomy position and supine lithotomy position. METHODS: A total of 82 patients with kidney calculi performed by suctioning flexible ureteroscopic lithotripsy with automatic control of renal Pelvic Pressure were retrospectively analyzed in single center. Group 1 included 47 patients treated via suctioning flexible ureteroscopy in the oblique supine lithotomy position. Group 2 included 35 patients treated in the supine lithotomy position. There were no significant differences in age, gender, or comorbidity rate between the two groups before surgery (P>0.05). Operative time, stone-free rate at postoperative day 30, renal Pelvic Pressure, postoperative complications, and length of hospital stay were compared between the two groups. RESULTS: Flexible ureteroscopy was successful after the first surgery in 73 patients and successful in the other nine patients after the placement of an indwelling double-J stent for 2 weeks. Compared to group 2, a significantly greater stone-free rate on postoperative day 30 and a significantly shorter operative time were noted in the group 2 (85.7% vs. 97.9%; 31.81±2.2 min vs. 23.4±14.9 min, P 0.05). CONCLUSIONS: Suctioning flexible ureteroscopic lithotripsy with automatic control of renal Pelvic Pressure in the oblique supine lithotomy position was safe and more effective than in the supine lithotomy position.

  • Analysis of the efficacy of suctioning flexible ureteroscopy with automatic control of renal Pelvic Pressure
    Chinese Journal of Urology, 2018
    Co-Authors: Xianxin Zhu, Guanghua Peng, Leming Song, Xiaolin Deng, Zhongsheng Yang, Lei Yao, Min Zeng, Shengfeng Liu
    Abstract:

    Objective To evaluate the efficacy and safety of suctioning flexible ureteroscopy with automatic control of renal Pelvic Pressure in the treament of intrarenal and proximal ureteral stones. Methods From November 2014 to December 2016, a total of 372 patients, including 200 males and 172 females, with upper urinary tract calculi were studied.The average age of patients was 48.1 years old.The average size of stone was 5-35mm, mean 15.7mm. There were 272 cases of renal calculi, 80 cases of ureteral calculi and 20 cases of renal calculi combined with ureteral calculi. There were 252 cases of single calculi and 127 cases of multiple calculi. There were 237 cases of urinary tract infection and 14 cases of bacteremia. All patients were treated by suctioning fiexible uretemscopy with automatic control of renal Pelvic Pressure by a patented intelligent system including an irrigation and suctioning platform and a ureteral access sheath with a Pressure-sensitive tip. Statistical analysis was performed regarding renal Pelvic Pressure, operative time, stone-free rates, and complications. Results Three hundred and thirty of 372 patients only accepted one surgery to remove the stone.There were 12 cases of upper ureteral calculi were converted to ureteroscope lithotripsy. Seventeen cases were converted to percutaneous nephrolithotomy due to significant ureteral stenosis.Seven cases who failed the first surgery due to difficulty in placing the ureteral access sheath but flexible ureteroscopy were successfully performed in these patients after indwelling a D-J stent for 2 weeks.No stone was found in 6 cases, and the soft endoscope of ureter was examined.In all patients, the renal Pelvic Pressure of the pelvis was controlled within 20 mmHg.The average operative time was 15-180 min(mean 58.9 min). The stone-free rates was 95.55%(322/337), the incidence of postoperative fever was 2.97% (10/337), the sepsis rate was 1.19% (4/337), the incidence of urinary sepsis was 0.89% (3/337), the incidence of lumbago caused by extravasation was 0.59% (2/337), and no peripheral viscera injury or death case.There was no statistically significant difference between preoperative and postoperative white and red blood cells (P>0.05). Conclusions This new type of suctioning flexible ureteroscopy with intelligent Pressure-control has the advantages of perfusion attraction, Pressure feedback, intelligent control and visualization of intracavity Pressure.It could be a new type of operation with high safety, low complication and high stone free rate. Key words: Kidney calculi; Flexible ureteroscopy; Intelligent control Pressure; Suction stone; Holmium laser

  • The clinical application of suctioning flexible ureteroscopy with automatically controlling renal Pelvic Pressure
    Chinese Journal of Urology, 2016
    Co-Authors: Xiaolin Deng, Leming Song, Jianrong Huang, Zhongsheng Yang, Jiuqing Zhong, Tairong Liu, Zuofeng Peng, Lunfeng Zhu, Xianxin Zhu
    Abstract:

    Objective To evaluate the safety and efficacy of suctioning flexible ureteroscopy with automatic control of renal Pelvic Pressure. Methods A total of consecutive 87 patients, including 54 male cases and 33 female cases, with upper urinary tract calculi were enrolled in this study from November 2014 to August 2015. The average size of stone was (15.9±4.2)mm. The average age was (48.2±13.1 )years old. All patients were performed suctioning flexible ureteroscopic lithotripsy under general anesthesia in low lithotomy position. They were treated by suctioning flexible ureteroscopy with automatic control of renal Pelvic Pressure (RPP) by a patented intelligent system including an irrigation and suctioning platform and a ureteral access sheath (F12/14) with a Pressure-sensitive tip. There are two connecting channels on the back end of the UAS, which are connected to the vacuum device with suctioning effect and Pressure monitoring feedback device, respectively. On the platform, control value was set at -15--5 mmHg(1 mmHg=0.133 kPa), RPP warning value was set at 20 mmHg, and RPP limit value was set at 30 mmHg. Infusion flow rate was set at 50-150 ml/min .Intraoperatively, Holmium laser was used to powderize the stone at 0.6-0.8J/pulse with a frequency of 20-30 Hz (fiber diameter 200μm). Statistical analysis was performed regarding RPP, operative time, stone-free rates, and complications. Results 76 of 87 patients only accepted one surgery to remove the stone. There were 7 cases who failed the first surgery due to difficulty in placing the ureteral access sheath but flexible ureteroscopy were successfully performed in these patients after indwelling a D-J stent for 2 weeks. Four cases were converted to percutaneous nephrolithotomy due to significant ureteral stenosis. For the 83 patients who underwent successful flexible ureterosocopy the actual RPP was controlled under 20 mmHg with clear operative visualization. The average operative time was (24.8±14.7) min. The stone-free rates at day 1 and day 30 were 86.7%(72/83) and 95.2%(79/83), respectively. Complication occurred in 16 cases. The ClavienⅠcomplications were noted in 14 cases, including pain in 6 cases , fever in 5 cases, nausea/vomiting in 2 cases and tachycardia 1 case. While ClavienⅡhypertension complications were noted in 2 cases. Conclusions Suctioning flexible ureteroscopy with automatically controlling RPP is technically feasible, safe, and efficacious for treating upper urinary tract calculi with the advantages of breaking stones at high efficacy and low complication rates. Key words: Upper urinary tract calculi; Renal Pelvic Pressure; Pressure feedback; Equipment

  • MP58-15 SUCTIONING FLEXIBLE URETEROSCOPY WITH AUTOMATIC CONTROL OF RENAL Pelvic Pressure: A PORCINE MODEL
    The Journal of Urology, 2016
    Co-Authors: Leming Song, Xiaolin Deng, Zuofeng Peng, Donghua Xie, Difu Fan, Tairong Liu
    Abstract:

    INTRODUCTION AND OBJECTIVES: We designed a novel technique of suctioning flexible ureteroscopy with automatic control of renal Pelvic Pressure (RPP) by a patented system including a Pressuremeasuring ureteral access sheath (UAS) and an irrigation and suctioning platform. We sought to compare RPP values measured by the irrigation and suctioning platform and a nephrostomy catheter at different phases of flexible ureteroscopy when flow rate was set at 100 mL/min. METHODS: Eight young female pigs with a total of 16 macroscopically normal upper urinary tract systems were included .Via a subcostal incision a 6-F catheter was placed into the renal pelvis for RPP measurement by connecting to a Pressure monitor. We then introduced the patented UAS (12-15F) retrogradely into the renal pelvis, through which the Pressure was measured by the platform. RPP was measured at baseline period, irrigation and suctioning period, and therapeutic period. RESULTS: Twelve renal pelves were successfully established animal models for flexible ureteroscopy and Pressure-measuring. Baseline RPP was 26.9 3.8mm Hg in the platform group and 26.3 5.2mm Hg in the nephrostomy group ( p 1⁄4 0.44). There was no significant difference on RPP between the 2 Pressure measuring methods either at irrigation and suctioning period (-5.21+/-2.11 vs. -3.59+/-1.45, p1⁄40.42) or therapeutic period (-5.81+/-2.47 vs. -3.73+/-2.19, p1⁄40.39). CONCLUSIONS: Renal Pelvic Pressure can be accurately and effectively monitored and controlled using the irrigation and suctioning platform with function of Pressure feedback and suctioning UAS with function of Pressure-measuring.

Leming Song - One of the best experts on this subject based on the ideXlab platform.

  • A Novel Technique to Intelligently Monitor and Control Renal Pelvic Pressure during Minimally Invasive Percutaneous Nephrolithotomy.
    Urologia internationalis, 2019
    Co-Authors: Xiaolin Deng, Leming Song, Jianrong Huang, Donghua Xie, Wanlong Tan
    Abstract:

    Objective To introduce a novel technique for intelligently monitoring and controlling renal Pelvic Pressure (RPP) in minimally invasive percutaneous nephrolithotomy (MPCNL) and to investigate its reliability and stability. Materials and methods A total of 63 kidney stone patients (41 males and 22 females) were enrolled in the study. The average stone size was 3.7 ± 1.1 cm. The average age was 41.6 ± 15.6 years old. All patients underwent MPCNL under combined spinal and epidural anesthesia in prone position. A ureteral catheter connected to an invasive blood Pressure monitor was retrogradely placed to measure renal Pelvic outlet Pressure. The MPCNL was performed with the aid of the patented device, including an irrigation and suctioning platform and a Pressure-measuring suctioning sheath. On the platform, the RPP control value was set at -5 mm Hg, and the RPP warning value was set at 20 mm Hg. RPP was measured during the irrigation and suctioning period (ISP), and therapeutic period (TP) when the infusion flow was set at 300, 400, and 500 mL/min, respectively, for 5 min. Results Sixty-three patients successfully underwent the procedure without serious complications. The mean operative time was 67 min (range 31-127 min). Three patients had residual stones >2 mm in size. No statistical significance was observed between the renal Pelvic outlet Pressure, platform RPP values, and RPP control values for the 300, 400, and 500 mL/min groups during the ISP and TP (p > 0.05). Conclusion The patented devices including the platform and the sheath can reliably and stably monitor and control RPP in real time and within a safe range during MPCNL.

  • suctioning flexible ureteroscopic lithotripsy in the oblique supine lithotomy position and supine lithotomy position a comparative retrospective study
    The Italian journal of urology and nephrology, 2018
    Co-Authors: Guanghua Peng, Leming Song, Jianrong Huang, Yuming Zhong, Xiaolin Deng
    Abstract:

    BACKGROUND: Flexible ureteroscopy is very valuable for treating upper urinary tract calculi. However, no report has yet compared the clinical outcomes of flexible ureteroscopy performed on patients in different body positions. Therefore, we compared the safety and efficacy of suctioning flexible ureteroscopic lithotripsy with automatic control of renal Pelvic Pressure in the oblique supine lithotomy position and supine lithotomy position. METHODS: A total of 82 patients with kidney calculi performed by suctioning flexible ureteroscopic lithotripsy with automatic control of renal Pelvic Pressure were retrospectively analyzed in single center. Group 1 included 47 patients treated via suctioning flexible ureteroscopy in the oblique supine lithotomy position. Group 2 included 35 patients treated in the supine lithotomy position. There were no significant differences in age, gender, or comorbidity rate between the two groups before surgery (P>0.05). Operative time, stone-free rate at postoperative day 30, renal Pelvic Pressure, postoperative complications, and length of hospital stay were compared between the two groups. RESULTS: Flexible ureteroscopy was successful after the first surgery in 73 patients and successful in the other nine patients after the placement of an indwelling double-J stent for 2 weeks. Compared to group 2, a significantly greater stone-free rate on postoperative day 30 and a significantly shorter operative time were noted in the group 2 (85.7% vs. 97.9%; 31.81±2.2 min vs. 23.4±14.9 min, P 0.05). CONCLUSIONS: Suctioning flexible ureteroscopic lithotripsy with automatic control of renal Pelvic Pressure in the oblique supine lithotomy position was safe and more effective than in the supine lithotomy position.

  • Analysis of the efficacy of suctioning flexible ureteroscopy with automatic control of renal Pelvic Pressure
    Chinese Journal of Urology, 2018
    Co-Authors: Xianxin Zhu, Guanghua Peng, Leming Song, Xiaolin Deng, Zhongsheng Yang, Lei Yao, Min Zeng, Shengfeng Liu
    Abstract:

    Objective To evaluate the efficacy and safety of suctioning flexible ureteroscopy with automatic control of renal Pelvic Pressure in the treament of intrarenal and proximal ureteral stones. Methods From November 2014 to December 2016, a total of 372 patients, including 200 males and 172 females, with upper urinary tract calculi were studied.The average age of patients was 48.1 years old.The average size of stone was 5-35mm, mean 15.7mm. There were 272 cases of renal calculi, 80 cases of ureteral calculi and 20 cases of renal calculi combined with ureteral calculi. There were 252 cases of single calculi and 127 cases of multiple calculi. There were 237 cases of urinary tract infection and 14 cases of bacteremia. All patients were treated by suctioning fiexible uretemscopy with automatic control of renal Pelvic Pressure by a patented intelligent system including an irrigation and suctioning platform and a ureteral access sheath with a Pressure-sensitive tip. Statistical analysis was performed regarding renal Pelvic Pressure, operative time, stone-free rates, and complications. Results Three hundred and thirty of 372 patients only accepted one surgery to remove the stone.There were 12 cases of upper ureteral calculi were converted to ureteroscope lithotripsy. Seventeen cases were converted to percutaneous nephrolithotomy due to significant ureteral stenosis.Seven cases who failed the first surgery due to difficulty in placing the ureteral access sheath but flexible ureteroscopy were successfully performed in these patients after indwelling a D-J stent for 2 weeks.No stone was found in 6 cases, and the soft endoscope of ureter was examined.In all patients, the renal Pelvic Pressure of the pelvis was controlled within 20 mmHg.The average operative time was 15-180 min(mean 58.9 min). The stone-free rates was 95.55%(322/337), the incidence of postoperative fever was 2.97% (10/337), the sepsis rate was 1.19% (4/337), the incidence of urinary sepsis was 0.89% (3/337), the incidence of lumbago caused by extravasation was 0.59% (2/337), and no peripheral viscera injury or death case.There was no statistically significant difference between preoperative and postoperative white and red blood cells (P>0.05). Conclusions This new type of suctioning flexible ureteroscopy with intelligent Pressure-control has the advantages of perfusion attraction, Pressure feedback, intelligent control and visualization of intracavity Pressure.It could be a new type of operation with high safety, low complication and high stone free rate. Key words: Kidney calculi; Flexible ureteroscopy; Intelligent control Pressure; Suction stone; Holmium laser

  • The clinical application of suctioning flexible ureteroscopy with automatically controlling renal Pelvic Pressure
    Chinese Journal of Urology, 2016
    Co-Authors: Xiaolin Deng, Leming Song, Jianrong Huang, Zhongsheng Yang, Jiuqing Zhong, Tairong Liu, Zuofeng Peng, Lunfeng Zhu, Xianxin Zhu
    Abstract:

    Objective To evaluate the safety and efficacy of suctioning flexible ureteroscopy with automatic control of renal Pelvic Pressure. Methods A total of consecutive 87 patients, including 54 male cases and 33 female cases, with upper urinary tract calculi were enrolled in this study from November 2014 to August 2015. The average size of stone was (15.9±4.2)mm. The average age was (48.2±13.1 )years old. All patients were performed suctioning flexible ureteroscopic lithotripsy under general anesthesia in low lithotomy position. They were treated by suctioning flexible ureteroscopy with automatic control of renal Pelvic Pressure (RPP) by a patented intelligent system including an irrigation and suctioning platform and a ureteral access sheath (F12/14) with a Pressure-sensitive tip. There are two connecting channels on the back end of the UAS, which are connected to the vacuum device with suctioning effect and Pressure monitoring feedback device, respectively. On the platform, control value was set at -15--5 mmHg(1 mmHg=0.133 kPa), RPP warning value was set at 20 mmHg, and RPP limit value was set at 30 mmHg. Infusion flow rate was set at 50-150 ml/min .Intraoperatively, Holmium laser was used to powderize the stone at 0.6-0.8J/pulse with a frequency of 20-30 Hz (fiber diameter 200μm). Statistical analysis was performed regarding RPP, operative time, stone-free rates, and complications. Results 76 of 87 patients only accepted one surgery to remove the stone. There were 7 cases who failed the first surgery due to difficulty in placing the ureteral access sheath but flexible ureteroscopy were successfully performed in these patients after indwelling a D-J stent for 2 weeks. Four cases were converted to percutaneous nephrolithotomy due to significant ureteral stenosis. For the 83 patients who underwent successful flexible ureterosocopy the actual RPP was controlled under 20 mmHg with clear operative visualization. The average operative time was (24.8±14.7) min. The stone-free rates at day 1 and day 30 were 86.7%(72/83) and 95.2%(79/83), respectively. Complication occurred in 16 cases. The ClavienⅠcomplications were noted in 14 cases, including pain in 6 cases , fever in 5 cases, nausea/vomiting in 2 cases and tachycardia 1 case. While ClavienⅡhypertension complications were noted in 2 cases. Conclusions Suctioning flexible ureteroscopy with automatically controlling RPP is technically feasible, safe, and efficacious for treating upper urinary tract calculi with the advantages of breaking stones at high efficacy and low complication rates. Key words: Upper urinary tract calculi; Renal Pelvic Pressure; Pressure feedback; Equipment

  • MP58-15 SUCTIONING FLEXIBLE URETEROSCOPY WITH AUTOMATIC CONTROL OF RENAL Pelvic Pressure: A PORCINE MODEL
    The Journal of Urology, 2016
    Co-Authors: Leming Song, Xiaolin Deng, Zuofeng Peng, Donghua Xie, Difu Fan, Tairong Liu
    Abstract:

    INTRODUCTION AND OBJECTIVES: We designed a novel technique of suctioning flexible ureteroscopy with automatic control of renal Pelvic Pressure (RPP) by a patented system including a Pressuremeasuring ureteral access sheath (UAS) and an irrigation and suctioning platform. We sought to compare RPP values measured by the irrigation and suctioning platform and a nephrostomy catheter at different phases of flexible ureteroscopy when flow rate was set at 100 mL/min. METHODS: Eight young female pigs with a total of 16 macroscopically normal upper urinary tract systems were included .Via a subcostal incision a 6-F catheter was placed into the renal pelvis for RPP measurement by connecting to a Pressure monitor. We then introduced the patented UAS (12-15F) retrogradely into the renal pelvis, through which the Pressure was measured by the platform. RPP was measured at baseline period, irrigation and suctioning period, and therapeutic period. RESULTS: Twelve renal pelves were successfully established animal models for flexible ureteroscopy and Pressure-measuring. Baseline RPP was 26.9 3.8mm Hg in the platform group and 26.3 5.2mm Hg in the nephrostomy group ( p 1⁄4 0.44). There was no significant difference on RPP between the 2 Pressure measuring methods either at irrigation and suctioning period (-5.21+/-2.11 vs. -3.59+/-1.45, p1⁄40.42) or therapeutic period (-5.81+/-2.47 vs. -3.73+/-2.19, p1⁄40.39). CONCLUSIONS: Renal Pelvic Pressure can be accurately and effectively monitored and controlled using the irrigation and suctioning platform with function of Pressure feedback and suctioning UAS with function of Pressure-measuring.

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  • Enhanced super-mini-PCNL (eSMP): low renal Pelvic Pressure and high stone removal efficiency in a prospective randomized controlled trial.
    World journal of urology, 2020
    Co-Authors: Wen Zhong, Junjun Wen, Linjie Peng, Guohua Zeng
    Abstract:

    In the present prospective randomized controlled trial (RCT), enhanced-SMP (eSMP) and conventional Chinese mini-PCNL (mPCNL) were compared to test the low renal Pelvic Pressure (RPP) and high stone removal efficiency in eSMP. Hundred patients with 2–5 cm renal calculus were enrolled. Renal Pelvic Pressure, operation time, lithotripsy time, removed stone volume, and complications were compared between eSMP and mPCNL statistically. There was no significant difference in removed stone volume between mPCNL and eSMP (8.09 ± 3.36 vs. 7.88 ± 3.07 mm3, t = 0.320, p = 0.750), lithotripsy time in mPCNL was longer than eSMP (49.6 ± 19.5 vs. 34.9 ± 14.2 min, t = 4.152, p   30 mmHg) in mPCNL was longer than eSMP (23.3 ± 16.9 vs. 3.7 ± 4.2 s, t = 7.710, p 

  • The Influence of Super-Mini Percutaneous Nephrolithotomy on Renal Pelvic Pressure In Vivo.
    Journal of endourology, 2018
    Co-Authors: Jad Alsmadi, Junhong Fan, Wei Zhu, Zhong Wen, Guohua Zeng
    Abstract:

    Abstract Objective: Renal Pelvic Pressure (RPP) is expected to rise during percutaneous procedures. A very small tract size was expected to bring high RPP, and super-mini percutaneous nephrolithoto...

  • does a smaller tract in percutaneous nephrolithotomy contribute to high renal Pelvic Pressure and postoperative fever
    Journal of Endourology, 2008
    Co-Authors: Wen Zhong, Guohua Zeng, Wenzhong Chen, Houmeng Yang
    Abstract:

    Objective: High renal Pelvic Pressure brings systemic absorption of irrigation fluid containing bacteria or endotoxins, which leads to postoperative fever. We inspected the renal Pelvic Pressure (RPP) in vivo during minimally invasive percutaneous nephrolithotomy (MPCNL) to investigate whether a 14- to 18-French percutaneous tract and perfusion would bring high RPP and postoperative fever. Patients and Methods: Between July 2005 and December 2007, 80 patients were selected for RPP measurement during MPCNL. The RPP was measured by a baroceptor connected to the open-ended ureteric catheter, which was indwelling retrogradely in the renal Pelvic. A computer recorded the RPP each second, and all the data were evaluated statistically with SPSS 12.0 software. Results: During MPCNL with 14-, 16-, 18-, and double-16-French percutaneous tracts, the mean RPP was 24.55, 16.49, 11.22, and 6.64 mm Hg, respectively. Logistical analysis suggested that postoperative fever did not correlate to gender (P = 0.195), age (P = ...

  • Effects of ureteral stents on rabbit upper urinary tract urodynamics
    Di 1 jun yi da xue xue bao = Academic journal of the first medical college of PLA, 2004
    Co-Authors: Zhi-chang Shan, Wenzhong Chen, Min-yi Xia, Bin Guo, Guohua Zeng
    Abstract:

    OBJECTIVE To explore the effects of ureteral stent placement on ureteral peristalsis and the time course of renal Pelvic Pressure changes. METHOD Forty rabbits were randomized equally into 8 groups, including a control group without placement of ureteral stents. The other 7 groups received ureteral stent placement, which were retained for 0, 1, 2, 3, 4, 7, and 12 weeks respectively. When the rabbits were bred for the specified time periods, ureteral peristalsis was observed and renal Pelvic Pressure measured. RESULT The renal Pelvic Pressure was initially increased after the stent placement, but then followed by gradual decreases. Ureteral peristalsis was not observed after the stent placement. CONCLUSION Ureteral stent is a factor for causing obstruction in normal ureter.