Intrarenal pressure monitoring in retrograde intrarenal surgery for high-infectious risk populations.
Real-time intrarenal pressure monitoring during retrograde intrarenal surgery was associated with low postoperative fever rates in patients with positive urine cultures.
Intrarenal pressure monitoring in retrograde intrarenal surgery for high-infectious risk populations.
To evaluate the feasibility of real-time intrarenal pressure (intrarenal pressure) monitoring using the LithoVue™ Elite (LVE) ureteroscope and assess postoperative infectious complications after retrograde intrarenal surgery (retrograde intrarenal surgery) in patients with positive urine cultures.
This multicenter, single-arm, prospective cohort study (August 2023-October 2024) included patients with upper urinary tract calculi and positive preoperative urine cultures who underwent retrograde intrarenal surgery with real-time intrarenal pressure monitoring via the LVE.
of patients with positive urine cultures developed fever after surgery with pressure kept low
The median operative time and artificial intelligence-corrected intrarenal pressure were 50 min (interquartile range: 36.8-80.0) and 13.3 mmHg (10.4-19.1), respectively.
Patients who developed postoperative fever were older (p = 0.019) and had longer preoperative ureteral stent indwelling times (p = 0.015).
Higher postoperative white blood cell counts and ipsilateral flank pain scores were also associated with elevated intrarenal pressure (p = 0.010 and p = 0.032, respectively).
Real-time intrarenal pressure monitoring using the LVE ureteroscope maintained low intrarenal pressures during retrograde intrarenal surgery and was associated with a low rate of postoperative fever in high-risk patients.
These findings suggest that incorporating intrarenal pressure monitoring into retrograde intrarenal surgery protocols is feasible and may improve pressure management in patients with positive urine cultures.