Irrigation with isoproterenol during ureterorenoscopy reduces pelvic pressure

The transport of urine in the upper urinary tract of the multicalyceal kidney was studied in healthy and chronically obstructed pigs in terms of renal pelvic pressure, rate of and coordination of ureteral contractions, and bolus volume. The variations of these parameters to diuresis was examined by incremental elevation of urine output effected by intravenous infusion of mannitol. In 16 healthy animals the mean variation in urine flow was 0.01-3.20 ml/min, the change in peristaltic rate ranged from 0.763 to 5.125 min-1, and bolus volume from 0.003 to 2.083 ml.. In 14 chronically obstructed kidneys, for a mean variation in urine flow of 0.006-5.4 ml/min, peristaltic rate ranged from 0.237 to 6.095 min-1 and bolus volume from 0.00 to 1.80 ml. Discoordinated contractions, bursts of peristalsis, and incompletely transmitted pelvic contractions were characteristic of a chronically obstructed system. These observations are compared with the unobstructed unicalyceal and multicalyceal kidney. The disrupting impact of chronic ureteral obstruction on the hierarchical organization of the pyeloureteral pacemaker system is discussed.

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Editorial Comment on: Endoluminal Isoproterenol Irrigation Decreases Renal Pelvic Pressure During Flexible Ureterorenoscopy: A Clinical Randomized, Controlled Study

European Urology ◽

10.1016/j.eururo.2008.03.095 ◽

2008 ◽

Vol 54 (6) ◽

pp. 1412-1413 ◽

Cited By ~ 1

Author(s):

Cristian Petre Ilie

Keyword(s):

Editorial Comment ◽

Randomized Controlled Study ◽

Controlled Study ◽

Flexible Ureterorenoscopy ◽

Randomized Controlled ◽

Pelvic Pressure

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Re: The Effects of Renal Pelvic Pressure Elevation on Isotope Nephrography and Renal Transit Time, an Experimental Study, by R. Tscholl, B. Rehmann, P. Stierli and J. Locher, J. Urol., 135: 629–633, 1986

The Journal of Urology ◽

10.1016/s0022-5347(17)43166-1 ◽

1987 ◽

Vol 138 (2) ◽

pp. 409-409

Author(s):

A. Piepsz ◽

H.R. Ham ◽

F. Collier ◽

M. Hall ◽

M. Verboven ◽

...

Keyword(s):

Experimental Study ◽

Transit Time ◽

Pressure Elevation ◽

Pelvic Pressure ◽

Renal Transit Time

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Intra-pelvic Pressure and Renal Function Studies in Experimental Chronic Partial Ureteric Obstruction1

British Journal of Urology ◽

10.1111/j.1464-410x.1973.tb00037.x ◽

2008 ◽

Vol 45 (1) ◽

pp. 2-7

Author(s):

F. A. W. SCHWEITZER

Keyword(s):

Renal Function ◽

Pelvic Pressure

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Hydrodynamics of the Normal Multicalyceal Pyeloureter in Pigs: The Pelvic Pressure Response to Increasing Flow Rates, Its Normal Ranges and Intra-Individual Variations

The Journal of Urology ◽

10.1016/s0022-5347(17)49165-8 ◽

1985 ◽

Vol 133 (4) ◽

pp. 704-708 ◽

Cited By ~ 21

Author(s):

J. Mortensen ◽

J.C. Djurhuus

Keyword(s):

Pressure Response ◽

Flow Rates ◽

Normal Ranges ◽

Individual Variations ◽

Pelvic Pressure

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Pelvic Pressure and Tubuloglomerular Feedback in Hydronephrosis

Kidney & Blood Pressure Research ◽

10.1159/000173353 ◽

1990 ◽

Vol 13 (4) ◽

pp. 181-189 ◽

Cited By ~ 1

Author(s):

Peter Morsing ◽

Erik G. Persson

Keyword(s):

Tubuloglomerular Feedback ◽

Pelvic Pressure

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Responses of primate spinothalamic tract neurons to renal pelvic distension

Journal of Neurophysiology ◽

10.1152/jn.1989.62.3.778 ◽

1989 ◽

Vol 62 (3) ◽

pp. 778-788 ◽

Cited By ~ 11

Author(s):

W. S. Ammons

Keyword(s):

Renal Pelvis ◽

Receptive Fields ◽

Response Threshold ◽

Spinothalamic Tract ◽

Renal Nerve ◽

C Fiber ◽

The Right ◽

Somatic Input ◽

Increased Activity ◽

Pelvic Pressure

1. Experiments were performed to examine responses of spinothalamic tract (STT) neurons to distension of the renal pelvis. Nineteen monkeys (Macaca fascicularis) were anesthetized with alpha-chloralose, paralyzed, and artificially ventilated. Fifty-four STT neurons in the T11-L2 segments were studied. Each cell was excited by renal nerve stimulation and had a somatic receptive field in the left flank and/or the abdomen. 2. Distension of the left renal pelvis to 50 mmHg for 20-30 s increased activity of 40 STT neurons. Two types of responses were observed. Six cells responded rapidly to the increase in renal pelvic pressure. Thereafter activity of these cells completely adapted. The other 34 cells also responded rapidly to the distension: however, the subsequent adaptation was not complete. Average activity before distension was 13 +/- 1 (SE) spikes/s. Distension increased activity to a peak of 42 +/- 3 spikes/s. Mean activity just before the end of the distension was 27 +/- 3 spikes/s. 3. The pelvic pressure-cell response relation was determined for 16 cells. Only one cell responded to a pressure of 20 mmHg. Three responded to 30 mmHg, and all others responded to 40 mmHg and higher. The average response threshold was 32 +/- 1 mmHg. Peak responses increased as distending pressure increased from 40-80 mmHg. Responses to a pressure of 100 mmHg were no greater than to 80 mmHg. Adapted levels of activity were also a function of distending pressure in the 40-80 mmHg range. 4. Probability of responses was unrelated to somatic input. However, cells with A delta- and C-fiber renal input were significantly more likely to respond to renal pelvic distension than cells with only A delta-renal input. Magnitude of responses to a pressure of 50 mmHg was not related to the type of renal input to the cells; however, among the cells tested at all pressures, cells with A delta- and C-fiber input had significantly greater responses to pressures of 80 and 100 mmHg. 5. Cells were studied in laminae I and IV-VII: responses were unrelated to laminar location. None of the 6 cells located in L2 responded to renal pelvic distension; 8 of 12 in L1 responded; 24 of 28 in T12 responded; and all 8 cells in T11 responded. 6. Stimulation of inhibitory receptive fields on the right hindlimb reduced activity of four cells to a significantly greater extent during pelvic distension than before pelvic distension.(ABSTRACT TRUNCATED AT 400 WORDS)

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