Associate Professor of Urology University of British Columbia
Introduction: We described the 1st in human use of the novel pressure sensing digital flexible ureteral scope, LithoVue Elite (Boston Scientific). By measuring intrarenal pressure in renal time, we were able to determine if the pressure may become elevated and contribute to potential postoperative complications. Methods: The LithoVue Elite Ureteroscope was used clinically and the first in human cases have occurred in Canada. A pressure bag set at 150 mmHg was used for pressurized irrigation. A ureteral access sheath was used at the discretion of the surgeon. Pressure readings were delivered 4 times a second. Readings of the intrarenal pressure are displayed on the video interface where the endoscopic image is viewed in real time (Figure 1). Results: Two cases are discussed here. One case shows that the intrarenal pressure with a ureteral access sheath ranges between 25-30 mmHg. In the exact same patient on the other kidney, no ureteral access sheath was used and the pressure is seen to be approximately 100 mmHg. Another case shows a patient under spinal anesthesia. When the pressure goes >115 mmHg, the patient describes pain and insertion of a UAS lowers the pressure to 15 mmHg and her pain subsides. Conclusions: The LithoVue Elite ureteroscope was able to monitor intrarenal pressure in real time. Ureteral access sheath use in these 2 cases showed a decrease in intrarenal pressure and where the patient was awake under spinal anesthetic, a UAS decreased her pain from high intrarenal pressure. The use of a new ureteroscope that can monitor intrarenal pressure in real time will help further investigation of the effects of intrarenal pressure during and after ureteroscopy. SOURCE OF Funding: None