The Impact Of One Week Of Pre-Stenting On Porcine Ureteral Diameter

You have accessJournal of UrologyStone Disease: Basic Research & Pathophysiology (MP07)1 Sep 2021MP07-19 THE IMPACT OF ONE WEEK OF PRE-STENTING ON PORCINE URETERAL DIAMETER Pengbo Jiang, Andrew Afyouni, Tori King, Samantha Dinh, Maged Ayad, Christina Kosmala, Akhil Peta, Andrew Brevik, Luke Limfuenco, Zhamshid Okhunov, Roshan Patel, Jaime Landman, and Ralph Clayman Pengbo JiangPengbo Jiang More articles by this author , Andrew AfyouniAndrew Afyouni More articles by this author , Tori KingTori King More articles by this author , Samantha DinhSamantha Dinh More articles by this author , Maged AyadMaged Ayad More articles by this author , Christina KosmalaChristina Kosmala More articles by this author , Akhil PetaAkhil Peta More articles by this author , Andrew BrevikAndrew Brevik More articles by this author , Luke LimfuencoLuke Limfuenco More articles by this author , Zhamshid OkhunovZhamshid Okhunov More articles by this author , Roshan PatelRoshan Patel More articles by this author , Jaime LandmanJaime Landman More articles by this author , and Ralph ClaymanRalph Clayman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001980.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteral access sheaths (UAS) are used during ureteroscopy to facilitate passage of the ureteroscope and the extraction of renal and ureteral stone fragments. Larger UAS have the potential to improve surgical outcomes, but are often avoided by surgeons due to concerns of ureteral injury. Using a novel UAS force sensor developed at our university, we sought to evaluate the impact of ureteral stent placement on ureteral circumference and the force needed to pass dilators of increasing size. METHODS: Seven juvenile female Yorkshire pigs (14 ureters) were included in the study. The inner circumference of each ureter was determined using a set of Cook urethral dilators (ranging from 8-24Fr in 2Fr increments, 37 cm in length) in combination with the UAS force sensor before and after one week of stent placement. Each ureter was randomized to receive either a 4.7 Fr or 7.0 Fr stent (20 cm in length). Maximum ureteral size was defined as successful passage of the dilator to the ureteropelvic junction at <6 Newtons (N) of force. Prior porcine and clinical studies have shown that 6N is the maximum force that can be placed on a UAS without incurring ureteral damage. Following passage of the largest dilator at 6N, flexible ureteroscopy was performed and a post-ureteroscopic lesion score (PULS) was recorded. RESULTS: After one week of stent placement, the median ureteral inner circumference increased from 12Fr to 16Fr (p <0.001). Thirteen (93%) of the 14 ureters increased in diameter following stent placement (table 1). The ureteral inner circumference recorded after stenting reached 18Fr in 36% of cases with a maximum size of 24 Fr. Right ureters had a greater increase in ureteral diameter after stenting than left ureters (p=0.005). Stent size did not have an impact on the change in ureteral diameter (p=0.573) (table 2). CONCLUSIONS: One week of ureteral stenting resulted in a 4F (1.33 mm) increase in the inner circumference (diameter) of porcine ureters. Right ureters enlarged to a greater degree than left ureters. Source of Funding: UCI Endourology Lab—Curiosity and Innovation Fund © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e147-e147 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Pengbo Jiang More articles by this author Andrew Afyouni More articles by this author Tori King More articles by this author Samantha Dinh More articles by this author Maged Ayad More articles by this author Christina Kosmala More articles by this author Akhil Peta More articles by this author Andrew Brevik More articles by this author Luke Limfuenco More articles by this author Zhamshid Okhunov More articles by this author Roshan Patel More articles by this author Jaime Landman More articles by this author Ralph Clayman More articles by this author Expand All Advertisement Loading ...