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Quantification of outflow resistance for ureteral drainage devices used during ureteroscopy

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Abstract

Purpose

Since renal pelvis pressure is directly related to irrigation flowrate and outflow resistance, knowledge of outflow resistance associated with commonly used drainage devices could help guide the selection of the type and size of ureteral access sheath or catheter for individual ureteroscopic cases. This study aims to quantitatively measure outflow resistance for different drainage devices utilized during ureteroscopy.

Methods

With measured irrigation flowrate and renal pelvis pressure, outflow resistance was calculated using a hydrodynamic formula. After placement of a drainage device into a silicone kidney-ureter model, a disposable ureteroscope with a 9.5-Fr outer diameter was inserted with its tip positioned at the renal pelvis. Irrigation was delivered through the ureteroscope from varying heights above the renal pelvis. Renal pelvis pressure was measured directly from the port of the kidney model using a pressure sensor (Opsens, Canada). Outflow resistance was determined by plotting flowrate versus renal pelvis pressure. All trials were performed in triplicate for each drainage device inserted.

Results

Flowrate was linearly dependent on renal pelvis pressure for all drainage devices tested. Outflow resistance values were 0.2, 1.1, 1.4, 3.9, and 6.5 cmH2O/[ml/min] for UAS 13/15 Fr, UAS 11/13 Fr, UAC 6 Fr, UAC 4.8 Fr, and UAC 4.0 Fr, respectively, across the range of commonly used irrigation flowrates.

Conclusions

In this study, outflow resistance of different ureteral drainage devices was quantitatively measured. This knowledge can be useful when selecting which type and size of drainage device to insert to maintain safe renal pelvis pressure during ureteroscopy.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

Funding for this project was provided through a research grant from Boston Scientific.

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Authors and Affiliations

  1. Department of Urology, University of Michigan, 4432 Medical Science I, 1301 Catherine Street, Ann Arbor, MI, 48109-5330, USA

    Hyung Joon Kim, Marne M. Louters, Julie J. Dau, Khurshid R. Ghani & William W. Roberts

  2. Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA

    Timothy L. Hall & William W. Roberts

Authors
  1. Hyung Joon Kim
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  2. Marne M. Louters
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  3. Julie J. Dau
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  4. Timothy L. Hall
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  5. Khurshid R. Ghani
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  6. William W. Roberts
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Contributions

HJK contributed to project development, data collection, manuscript writing, and data analysis; WWR contributed to manuscript writing/editing, data analysis, critical revision, study management; and KRG, TLH, MML, and JJD contributed to manuscript editing.

Corresponding author

Correspondence to Hyung Joon Kim.

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Conflict of interest

WW Roberts has a consulting relationship with Boston Scientific. KR Ghani has consulting relationships with Boston Scientific, Lumenis, Olympus, Coloplast, and Karl Storz. MM Louters, HJ Kim, JJ Dau, and TL Hall have no disclosures.

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Kim, H.J., Louters, M.M., Dau, J.J. et al. Quantification of outflow resistance for ureteral drainage devices used during ureteroscopy. World J Urol 41, 873–878 (2023). https://doi.org/10.1007/s00345-023-04299-x

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  • DOI: https://doi.org/10.1007/s00345-023-04299-x

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