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01-08-2012 | Original Paper

Distension of the renal pelvis in kidney stone patients: sensory and biomechanical responses

Authors: Katja Venborg Pedersen, Donghua Liao, Susanne Sloth Osther, Asbjørn Mohr Drewes, Hans Gregersen, Palle Jörn Sloth Osther

Published in: Urolithiasis | Issue 4/2012

Abstract

The pathogenesis of symptoms in urolithiasis is poorly understood. Traditionally increased endoluminal pressure is considered the main mechanism causing pain in the upper urinary tract but clinical data are sparse. The aim of the present study was to develop a new model related to mechanosensation in order to describe the geometric and mechanical properties of the renal pelvis in patients with kidney stone disease. Pressure measurement in the renal pelvis was done during CT-pyelography in 15 patients who underwent percutaneus nephrolithotomy. The sensory intensity was recorded at the thresholds for first sensation and for pain. 3D deformation and strain were calculated in five patients. The deformation of pelvis during distension was not uniform due to the complex geometry. The pelvis deformed to 113 ± 6% and 115 ± 11% in the longitudinal and circumferential directions, respectively. Endoluminal pressure in the renal pelvis corresponded positively to the sensory ratings but the referred pain area was diffuse located and varied in size. The present study provides a method for describing the mechanosensory properties and 3D deformation of the complex renal pelvis geometry. Although there was a relation between pressure and pain score, the non-homogenous spatial strain distribution suggests that the 3D biomechanical properties of the renal pelvis are not reflected by simple estimates of tension based on pressure and volume.

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The curvature is a parameter of the geometrical property. The curvature of a curve is by definition the reciprocal of the radius of the osculating circle. The curvature is taken to be positive if the curve turns in the same direction as the surface’s chosen normal, and otherwise negative. The smaller curvature the flatter is the surface.

At each point P of a differentiable surface in 3D Euclidean space, a normal plane at P is one that contains the normal, and will therefore also contain a unique direction tangent to the surface and cut the surface in a plane curve. This curve will in general have different curvatures for different normal planes at P. The principal curvatures and second principal curvature at p are the maximum and minimum values of this curvature.

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Title: Distension of the renal pelvis in kidney stone patients: sensory and biomechanical responses
Authors: Katja Venborg Pedersen
Donghua Liao
Susanne Sloth Osther
Asbjørn Mohr Drewes
Hans Gregersen
Palle Jörn Sloth Osther
Publication date: 01-08-2012
Publisher: Springer-Verlag
Published in: Urolithiasis / Issue 4/2012
Print ISSN: 2194-7228
Electronic ISSN: 2194-7236
DOI: https://doi.org/10.1007/s00240-011-0425-3

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Distension of the renal pelvis in kidney stone patients: sensory and biomechanical responses

Abstract

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