Novel pressure- and temperature-controlled flexible ureteroscope system with a suction ureteral access sheath: a multicenter retrospective feasibility study

Abstract

Purpose: The purpose of this study was to assess the feasibility of a pressure-controlled and temperature-controlled flexible ureteroscope system (PT Scope™) during flexible ureteroscopy.

Materials and methods: We developed the PT Scope™, a novel ureteroscope system with capabilities for monitoring and controlling intrarenal pressure and temperature to maintain them within set parameters. Data were retrospectively collected from 48 consecutive patients diagnosed with upper urinary tract stones who underwent flexible ureteroscopic lithotripsy using the PT Scope™ across five centers in China. Analyses focused on 24-h postoperative stone-free rates, intrarenal pressure and temperature measurements, and other procedural data.

Results: Among the 48 patients treated with the PT Scope™ system, a significant stone-free rate of 89.6% was achieved within 24 h postoperation, without any instances of intraoperative complications such as perforation or mucosal hemorrhage. Only two patients reported mild postoperative pain and were managed with NSAIDs, and there were no cases of postoperative fever or sepsis. The average maximum intrarenal pressure and temperature were recorded at 30.2 ± 4.20 mmHg and 36.6 ± 4.27 °C, respectively. Notably, during lithotripsy, both the pressure and temperature were maintained below 30 mmHg and 43 °C for 99% of the procedure duration, respectively.

Conclusion: This preliminary investigation indicates that the PT Scope™ is a safe and effective tool for the treatment of upper urinary tract stones, offering the benefit of regulating intrarenal pressure and temperature within predetermined limits. These findings support the feasibility of the system for clinical application.

Keywords: Flexible ureteroscope; Intrarenal pressure; Intrarenal temperature; Lithotripsy.