Novel non-invasive intrarenal pressure monitoring devices in flexible ureteroscopy: an in-vitro comparative study

Abstract

Purpose: Intrarenal pressure monitoring is emerging as an important tool in flexible ureteroscopy. Novel non-invasive intrarenal pressure monitoring devices are introduced. We evaluated the pressure readings simultaneously across four novel non-invasive intrarenal pressure monitoring devices against the urodynamic system. Materials and methods: Two IRP monitoring single-use flexible ureteroscopy: LithoVue Elite™ (Boston Scientific Corporation, Marlborough, MA, USA); ZebraScope™ (Happiness Works Medical Instruments Co., Ltd, Anhui, China); two intelligent intrarenal system integrated with irrigation and suction via flexible and navigable suction ureteral access sheath: i-MIMERsys™ (ZSR Biomedical Technology Co., Ltd, Dongguan, China); Tidor™ (YiGao Medical Technology Co., Ltd, Zhejiang, China) were tested against MMS/Laborie Nexam Pro Urodynamic System (Laborie Medical Technologies Corporation, Portsmouth, USA). Results: The degree of agreement between measurements from urodynamic system and the experimented device was demonstrated by Bland–Altman plots and intraclass correlation coefficients (ICCs). Compared to the urodynamic system, the average difference ± standard deviation of LithoVue Elite™ was 0.26 ± 1.75mmHg; ZebraScope™ 3.22 ± 1.86mHg, i-MIMERsys™ 0.96 ± 2.26mmhg; Tidor™ 1.09 ± 2.57mmHg. Pressure measured by LithoVue Elite™, ZebraScope™, i-MIMERsys™ and Tidor™ to urodynamic system showed excellent ICCs of 0.975 (p < 0.001), 0.915(p = 0.016), 0.955(p < 0.001) and 0.937(p < 0.001) respectively. Conclusion: Pressure recordings from four novel non-invasive intrarenal monitoring devices, namely flexible ureteroscopes—LithoVue Elite™, ZebraScope™; and intelligent IRP monitoring systems via flexible and navigable suction ureteral access sheaths — i-MIMERsys™, Tidor™. were comparable to that of urodynamic system. This in-vitro study verifies that such non-invasive devices provide reliable data for monitoring intrarenal pressure changes.