Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China.
Department of Urology, Beijing Jiangong Hospital, Beijing, China.
World J Urol. 2024 Sep 20;42(1):533. doi: 10.1007/s00345-024-05209-5.
To develop a novel adaptation of the Whitaker test for assessing the surgical effects of ileal ureter replacement (IUR), and to evaluate its feasibility and effect in the postoperative evaluation.
From November 2021 to September 2023, patients undergoing the modified Whitaker test following IUR were prospectively enrolled. The relative pressure was defined as the pelvis pressure minus the bladder pressure. Successful nephrostomy removal was defined as absence of symptoms and improved or stable hydronephrosis.
The 51 ureters from 39 patients underwent the modified Whitaker test after IUR. The modified Whitaker test was performed successfully on all patients without any reported discomfort. The relative pressure of 47 ureters kept steady (< 15 cmHO) throughout the examination with well ileal ureter peristalsis and was classified into type I. The relative pressure of 2 ureters increased with perfusion reaching a range of 15-22 cmHO, with well ileal ureteral peristalsis observed (type II). The relative pressure of 2 ureters increased along with perfusion, with weakening of ileal ureter peristalsis or a leakage of contrast medium, and the relative pressure surpassed 22 cmHO (type III). Nephrostomy tubes were promptly removed for type I and type II ureters, while removal for type III ureters occurred after a 2-month period. None of the 39 patients required additional interventions for recurrent obstruction.
The modified Whitaker test was a safe and effective approach for the evaluation of surgical effects of IUR, offering additional evidence to assess the safety of nephrostomy tube removal.
开发一种新的惠特克（Whitaker）试验改编版，用于评估回肠代输尿管术（IUR）的手术效果，并评估其在术后评估中的可行性和效果。
2021 年 11 月至 2023 年 9 月，前瞻性纳入接受 IUR 后改良惠特克试验的患者。相对压力定义为骨盆压力减去膀胱压力。成功拔除肾造瘘管定义为无症状和改善或稳定的肾积水。
39 例患者的 51 根输尿管接受了 IUR 后的改良惠特克试验。所有患者均成功完成改良惠特克试验，无任何不适报告。47 根输尿管的相对压力在整个检查过程中保持稳定（<15cmHO），回肠输尿管蠕动良好，分为 I 型。2 根输尿管的相对压力随着灌注而增加，达到 15-22cmHO 范围，观察到回肠输尿管蠕动良好（II 型）。2 根输尿管的相对压力随着灌注而增加，回肠输尿管蠕动减弱或造影剂泄漏，相对压力超过 22cmHO（III 型）。I 型和 II 型输尿管立即拔除肾造瘘管，而 III 型输尿管在 2 个月后拔除。39 例患者均无需再次干预治疗复发性梗阻。
改良惠特克试验是评估 IUR 手术效果的一种安全有效的方法，为评估肾造瘘管拔除的安全性提供了额外证据。
