Impact of pre-stenting and bladder dranaige on intrapelvic pressure during retrograde intrarenal surgery

Yeni S., KILIÇARSLAN H., OCAKOĞLU G., COŞKUN B., ÇİÇEK M. Ç., GÜNSEREN K. Ö., ...More

BJUI Compass, vol.6, no.2, 2025 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 6 Issue: 2
  • Publication Date: 2025
  • Doi Number: 10.1002/bco2.490
  • Journal Name: BJUI Compass
  • Journal Indexes: Scopus
  • Keywords: double J stent catheter, Intrapelvic pressure, laser stone lithotripsy, RIRS, Uretral bladder catheter
  • Bursa Uludag University Affiliated: Yes

Abstract

Purpose: This study aims to assess the effect of pre-stenting and bladder drainage on intrapelvic pressure (IP) during Retrograde Intrarenal Surgery (RIRS). Methods: Eighty-five consecutive patients were prospectively enrolled and meticulously recorded in a data form. Forty-two patients meeting the inclusion criteria after applying exclusion factors. The patients were divided into two groups: Group 1 (21 patients with preoperative JJ stents) and Group 2 (21 patients without preoperative JJ stents). IP was measured during RIRS, and the impact of various factors, including pre-stenting, bladder drainage and hydronephrosis (HN) grade, on IP was analysed through univariate and multiple linear regression. Results: The perioperative mean highest IP (78 ± 18.2 mmHg vs. 110 ± 23.9 mmHg), median lowest IP (29 mmHg vs. 42 mmHg) and median overall IP (41 mmHg vs. 69 mmHg) were significantly lower in Group 1 compared to Group 2 (all p < 0.001). Multivariate analysis showed that pre-stenting and mild HN (Grade 0–1) were independent predictors of reduced IP. Conclusion: Pre-stenting led to a significant reduction in IP during RIRS, likely due to passive ureteral dilation. Additionally, bladder drainage with urethral catheter further decreased IP. These findings suggest that pre-stenting and bladder drainage should be considered as strategies to reduce IP during RIRS, potentially improving surgical outcomes.