2. UroToday Home
  3. Recent Abstracts
  4. Urologic Oncology
  5. Renal Cancer

Ureteroscopic Doppler Ultrasonography: Mapping Renal Blood Flow From Within the Collecting System.

Introduction: Herein we provide the first report regarding in vivo porcine renal forniceal, papillary, and infundibular blood flow at the urothelial level using a novel ureteroscopic Doppler transducer.

Materials and Methods: Nephroureteroscopy was performed on eleven female Yorkshire pigs to map the forniceal, papillary, and infundibular blood flow. A Doppler transducer was mounted to a 3 Fr, 120 cm catheter; the probe was passed through the working channel of a flexible ureteroscope. Blood flow was categorized from 0 (no flow) to 3 (highest flow) based on auditory intensity. At each site, a holmium laser probe was activated until it penetrated approximately 1cm into each of the examined areas; bleeding times were recorded.

Results: The frequency of the Doppler transducer signal was proportional to the blood velocity within the vessel with expected increased bleeding times confirmed following puncture with a Holmium laser. Analysis demonstrated that the 6 o'clock position of the fornix had significantly greater blood flow as compared to any other forniceal location (p<0.001). The center of each papilla had the least blood flow (p<0.001). Blood flow was significantly higher at the infundibular level compared to the calyceal fornices at all locations (anterior, posterior, upper pole, mid-kidney, and lower pole) (p<0.001).

Conclusions: In a porcine model, a miniaturized Doppler ultrasound probe used during ureteroscopy demonstrated that the renal papilla had the least amount of blood flow while the infundibula had the highest blood flow. These data may serve to inform site selection during percutaneous nephrostomy placement.

Citation: Patel, Roshan M, Luke Limfueco, Shlomi Tapiero, Mitchell O'Leary, Vinay Cooper, Egor Parkhomenko, and Kamaljot S. Kaler et al. 2020. "Ureteroscopic Doppler Ultrasonography: Mapping Renal Blood Flow From Within The Collecting System". Journal Of Endourology. doi:10.1089/end.2019.0884.

Authors: Patel RM,1 Limfueco L,2 Tapiero S,3 O'Leary M,4 Cooper V,5 Parkhomenko E,6 Kaler KS,7 Okhunov Z,8 Regan D,9 Landman J,10 Clayman RV11

  1. University of California Irvine, 8788, Urology, 333 City Blvd West, Suite 2100, Irvine, California, United States, 92697; .
  2. University of California Irvine, 8788, Urology, Orange, California, United States; .
  3. UCI, 8788, Urology, Orange, California, United States; .
  4. University of California, Irvine, Urology, 333 City Blvd W, Orange, California, United States, 92868; .
  5. University of California Irvine School of Medicine, 12219, Urology, 333 The City Blvd W, Orange, California, United States, 92868; .
  6. Boston University Medical Center, 1836, Boston, Massachusetts, United States; .
  7. University of Calgary, 2129, Urology, Calgary, Alberta, Canada; .
  8. University of California, Irvine, Urology, 333 City Boulevard, Suite 2100, 333 City Boulevard, Suite 2100, Orange, California, United States, 92868; .
  9. Vascular Technology Inc, 483053, Nashua, New Hampshire, United States .
  10. University of California Irvine, Urology, 333 City Blvd West, Orange, California, United States, 92868; .
  11. Univ. of California, Irvine, Urology, 101 The City Drive South, Bldg. 55, Room 304, Route 81, Irvine, California, United States, 92868; .