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dc.contributor.authorFarag, Matthew-
dc.contributor.authorTimm, Brennan-
dc.contributor.authorDavis, Niall-
dc.contributor.authorWong, Lih-Ming-
dc.contributor.authorBolton, Damien M-
dc.contributor.authorJack, Gregory S-
dc.identifier.citationJournal of Endourology 2020; 34(9): 914-918en
dc.description.abstractIntroduction and Objectives: A variety of irrigation systems are available during ureteroscopy. We sought to compare gravity-driven pressure bags with hand-operated irrigation pumps in terms of postoperative complications after ureteroscopy with lithotripsy. Methods: A retrospective analysis of 234 patients undergoing flexible ureteropyeloscopy with laser lithotripsy by 24 supervised trainees over 4 years at a single teaching institution. Patients were divided into those who had procedures performed by using gravity-driven pressure bags fixed at 60 to 204 cm H2O, vs those who had procedures performed by using a hand-operated irrigation pump capable of delivering 1 to 10 mL per flush. Variables including surgical duration, hypotension, fever, sepsis, and hematuria were extracted from the charts, along with the surgical techniques utilized. Statistical analyses included chi-squared tests and Student's t-tests. Results: There were no differences in gender, age, indication, or stone size in the two groups. Postoperative systemic inflammatory response syndrome was significantly greater in the hand-assisted n = 11/144 (7.6%) compared with the fixed irrigation group n = 1/90 (1.1%); p = 0.032. Emergency room presentations were greater in the hand irrigation group, n = 46/144 (32%) vs n = 12/90 (13%) in the pressure-bag irrigation, p = 0.002. Postoperative fever was also greater in the hand pump irrigation cohort compared with the continuous pressure cohort (13/144 [9%] vs 1/90 [1%], p = 0.011). No statistical difference was found between the two groups with respect to stone clearance and subsequent procedures required (p = 0.123). Conclusions: This analysis suggests that using continuous flow irrigation at a fixed maximum pressure of 150 mmHg (204 cm H2O) or less may result in decreased pain, infection, and sepsis compared with handheld pressure irrigation.en
dc.subjectintrarenal pressureen
dc.subjectretrograde intrarenal surgeryen
dc.titlePressurized-Bag Irrigation Versus Hand-Operated Irrigation Pumps During Ureteroscopic Laser Lithotripsy: Comparison of Infectious Complications.en
dc.typeJournal Articleen
dc.identifier.journaltitleJournal of Endourologyen
dc.identifier.affiliationDepartment of Urology, St Vincents Hospital, Melbourne, Australiaen
dc.identifier.affiliationDepartment of Urology, Tallaght Hospital, Dublin, Ireland..en
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