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Purpose <p>To evaluate the effect of irrigation fluid height on intrarenal pressure (IRP) when using flexible ureteroscopes with direct in-scope suction (DISS) under different irrigation conditions.</p> Materials and methods <p>An ex-vivo experimental study utilizing a 7.5Fr PU3033AH and 9.2Fr PU400A flexible ureteroscopes was performed with irrigation bags at heights of 60, 100, and 140&#xa0;cm using gravity, manual pump and automated pump irrigation (40, 60, 80, and 100mmHg). The evaluated parameters included initial IRP, pressure decrease after 1&#xa0;s of suctioning, time to collapse the pelvicalyceal system, and time to regain initial IRP.</p> Results <p>The 9.2Fr DISS demonstrated higher flow rates in all settings compared to the 7.5Fr scope. Increasing irrigation height (60&#xa0;cm to 140&#xa0;cm) significantly enhanced flow rates with gravity irrigation for both scopes. The automated pump maintained consistent IRP regardless of irrigation height, while gravity and manual pump irrigation showed higher IRP with increased fluid height. The 9.2Fr scope generated higher baseline IRPs but demonstrated more efficient pressure reduction with when suction was applied.</p> Conclusions <p>The height of irrigation fluid significantly impacts flow rates and IRP during flexible ureteroscopy with DISS technology when using gravity and manual pump irrigation systems and this varies considerably with different diameter working channels. Automated pump irrigation maintains a consistent pressure regardless of fluid height. The 9.2Fr scope provides higher flow rates and more efficient suction capabilities, although it results in higher baseline intrarenal pressures.</p>

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Does the height of the irrigation fluid and irrigation method affect the intrarenal pressure using ureteroscopes with direct in-scope suction feature? An ex-vivo experimental study

  • 期刊论文

  • 发表日期：

    2025年10月22日

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  • Arman Tsaturyan,
  • Victoria Jahrreiss,
  • Vineet Gauhar,
  • Arkadya Musayelyan,
  • Hayk Grigoryan,
  • Armen Muradyan,
  • Eugenio Ventimiglia,
  • Evangelos Liatsikos,
  • Panagiotis Kallidonis,
  • Marco Lattarulo,
  • Pier Paolo Prontera,
  • Steffi Kar Kei Yuen,
  • Olivier Traxer,
  • Begona Ballesta Martinez,
  • Bhaskar Somani,
  • Amelia Pietropaolo

摘要

Purpose

To evaluate the effect of irrigation fluid height on intrarenal pressure (IRP) when using flexible ureteroscopes with direct in-scope suction (DISS) under different irrigation conditions.

Materials and methods

An ex-vivo experimental study utilizing a 7.5Fr PU3033AH and 9.2Fr PU400A flexible ureteroscopes was performed with irrigation bags at heights of 60, 100, and 140 cm using gravity, manual pump and automated pump irrigation (40, 60, 80, and 100mmHg). The evaluated parameters included initial IRP, pressure decrease after 1 s of suctioning, time to collapse the pelvicalyceal system, and time to regain initial IRP.

Results

The 9.2Fr DISS demonstrated higher flow rates in all settings compared to the 7.5Fr scope. Increasing irrigation height (60 cm to 140 cm) significantly enhanced flow rates with gravity irrigation for both scopes. The automated pump maintained consistent IRP regardless of irrigation height, while gravity and manual pump irrigation showed higher IRP with increased fluid height. The 9.2Fr scope generated higher baseline IRPs but demonstrated more efficient pressure reduction with when suction was applied.

Conclusions

The height of irrigation fluid significantly impacts flow rates and IRP during flexible ureteroscopy with DISS technology when using gravity and manual pump irrigation systems and this varies considerably with different diameter working channels. Automated pump irrigation maintains a consistent pressure regardless of fluid height. The 9.2Fr scope provides higher flow rates and more efficient suction capabilities, although it results in higher baseline intrarenal pressures.