title: In VitroComparison of Maximum Pressure Developed by Irrigation Systems in a Kidney Model.
abstract: Purpose:To evaluatein vitrothe maximum pressure generated in an artificial kidney model when people of different levels of strengths used various irrigation systems.Materials and Methods:Fifteen people were enrolled and divided into three groups based on their strengths. Individual strength was evaluated according to the maximum pressure each participant was able to achieve using an Encore™ Inflator. The irrigation systems evaluated were as follows: T-Flow™ Dual Port, Hiline™, continuous flow single action pumping system (SAPS™) with the system close and open, Irri-flo II™, a simple 60-mL syringe, and Peditrol™. Each irrigation system was connected to URF-V2 ureteroscope, which was inserted into an artificial kidney model. Each participant was asked to produce the maximum pressure possible with every irrigation device. Pressure was measured with the working channel (WC) empty, with a laser fiber, and a basket inside.Results:The highest pressure was achieved with the 60 mL-syringe system and the lowest with SAPS continuous version system (with continuous irrigation open), compared to the other irrigation devices (p< 0.0001). Irrespective of the irrigation system, there was a significant difference in the pressure between the WC empty and when occupied with the laser fiber or the basket inside it (p< 0.0001). The stratification between the groups showed that the most powerful group could produce the highest pressure in the kidney model with all the irrigation devices in almost any situation. The exception to this was the T-Flow system, which was the only device where no statistical differences were detected among these groups.Conclusion:The use of irrigation systems can often generate excessive pressure in an artificial kidney model, especially with an unoccupied WC of the ureteroscope. Depending on the strength of force applied, very high pressure can be generated by most irrigation devices irrespective of whether the scope is occupied or not.
authors.affiliation: Department of Urology, San Raffaele Hospital, Ville Turro Division, Milan, Italy.|Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris, Paris, France.
authors.forename: Silvia
authors.initials: S
authors.lastname: Proietti
authors.affiliation: Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris, Paris, France.|Department of Urology, East Surrey Hospital, Surrey and Sussex Healthcare NHS, Redhill, United Kingdom.
authors.forename: Laurian
authors.initials: L
authors.lastname: Dragos
authors.affiliation: Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom.
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Somani
authors.affiliation: Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris, Paris, France.|Department of Human Pathology, Unit of Urology, University of Messina, Messina, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Butticè
authors.affiliation: Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris, Paris, France.|Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Talso
authors.affiliation: Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris, Paris, France.|Department of Urology, Fundacion Puigvert Universitat Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Esteban
authors.initials: E
authors.lastname: Emiliani
authors.affiliation: Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris, Paris, France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Baghdadi
authors.affiliation: Department of Urology, San Raffaele Hospital, Ville Turro Division, Milan, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Giusti
authors.affiliation: Department of Urology, GRC Lithiase (Groupe Recherche Clinique), Université Pierre et Marie Curie - Paris VI, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Traxer
keywords: flexible ureteroscopy; intrarenal pressure; irrigation systems