To evaluate the intrarenal pressure parameters of the 9.2 Fr (5.1 Fr working channel) and 7.5 Fr (3.6 Fr working channel) flexible ureteroscopes with direct-in-scope suction (DISS) in an ex vivo experimental setting.
We performed an experimental study using an ex vivo porcine model using two DISS single-use digital videoureteroscopes: a 7.5 Fr PU3033AH and 9.2 Fr PU400A (Pusen, Zhuhai, China). Intrarenal pressures (IRPs) were measured with an automated irrigation pump set at 40, 60, 80, 100 mmHg, manual hand pumping and gravity fed-irrigation, with suction applied continuously and intermittently at 3-second intervals.
Higher IRPs were documented when the 9.2 Fr flexible ureteroscope was used compared to the 7.5 Fr scope, regardless of the irrigation setup. The highest IRP (45 mmHg) was documented with the 9.2 Fr scope, using manual pump irrigation and intermittent pumping with no suction. In contrast, the lowest IRP was reported with the 7.5 Fr scope and the automated pump at 40 mmHg. The pressure difference following 1second of suctioning was more pronounced with 9.2 Fr compared to 7.5 Fr. The 9.2 Fr ureteroscope with the 5.1 Fr working channel resulted in significantly shorter time to regain the initial IRP.
For the first time in experimental studies we noted that irrigation through a wider 5.1 Fr working channel raises the baseline IRP faster than the classic 3.6 Fr working channel. Although these findings should be further investigated in a clinical setting, they should be taken into consideration to select the optimal strategy, to keep IRP at safe levels, and avoid complications.
Central European journal of urology. 2025 Aug 31 [Epub]
Arman Tsaturyan, Begoña Ballesta Martinez, Laurian Dragos, Hakob Sargsyan, Arthur Grabsky, Armen Muradyan, Sergey Fanarjyan, Artak Madatyan, Eugenio Ventimiglia, Angelis Peteinaris, Evangelos Liatsikos, Panagiotis Kallidonis, Steffi Kar Kei Yuen, Vineet Gauhar, Olivier Traxer, Bhaskar Somani, Amelia Pietropaolo
Department of Urology, Yerevan State Medical University, Yerevan, Armenia., Department of Urology, University Hospital del Vinalopo, Alicante, Spain., Department of Urology, University of Cambridge NHS Trust, United Kingdom., EAU Young Academic Urologists (YAU) Urolithiasis and Endourology Working Group Arnhem, Arnhem, The Netherlands., Department of Urology, University of Patras, Greece., Advancing Suction and Pressure and Innovative Research in Endourology (ASPIRE), Yerevan, Armenia.