Monitoring of renal pelvic pressure in patients with hydronephrosis.

ABSTRACT

A diagnostic method for the determination of obstructions in the pelvoureteral junction in patients with suspected idiopathic hydronephrosis is described and discussed. Two microtransducer catheters (MTCs) with infusion lumens are inserted under fluoroscopic control, one into the renal pelvis and the other in the perirenal space as a reference. The pressure values obtained are stored on a portable microcomputer system, carried by the ambulatory patients. Renal pelvic pressure, intra-abdominal pressure and differential pressure are calculated and displayed as time-pressure diagrams on a plotter. The pressures can be measured for long periods (3-24 h). Furthermore, steady state conditions can be evaluated during pelvic infusion of saline. The results from the pressure measurements are compared with clinical and radiological evaluations. Our results show that this method of long-term monitoring of intrapelvic pressure together with intra-abdominal pressure contributes to the evaluation of patients with suspected pelvoureteral obstructions and complements other methods in the preoperative investigation. However, this study reveals difficulties with measurements of intra-abdominal pressure. Carrying the equipment was not inconvenient for the patients.