Thread by @Urologeman

RIRS and Pressure

1/ Hi everyone! Warning - not a "COVID" tweet

I'd like to present a little summary on intrarenal pressure (IRP) during RIRS

1 cmH2O = 0.73 mmHg

IRP should be kept lower than 30 cm H2O

Lowest irrigation flow (IF) to keep a clear vision is 21 ml/min

2/

With no Ureteral Access Sheath (UAS) gravity irrigation pressure of 50, 100, and 200 cm H2O will lead to 15, 30, and 55 cm H2O of IRP with IF of 23, 47 and 80 mL/min correspondingly

The maximal IRP during manual irrigation can reach 598.4 cm H2O

3/

With gravity IP of 100 cm H2O with a 242 μm laser fiber in the working channel and no outflow resistance IF was 14 to 15 mL/minute

Difference between UAS and outer diameter of scope should be no less than 3 Fr

IRPs remain lower than 30 cmH2O if a UAS bigger than 10/12 F

4/

No significant differences between IRP and IF of the 12/14F and the 14/16F UAS.

bit.ly/2yRVQFx bit.ly/3aQRRX0 bit.ly/3aHkWnS bit.ly/3aRvnoS bit.ly/2y0PCmU bit.ly/2YiENY6
bit.ly/2SjPHc7 bit.ly/3bQ9tUh

I have a little experience with #clearpetra for RIRS - wouldn’t say it was helpful

#UroSoMe #intrarenalpressure

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