Model study on the influence of different degrees of hydronephrosis on the hydrodynamic changes in renal pelvis
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    Abstract:

    Objective The urodynamic changes of urine at different degrees of hydronephrosis were studied through the computational fluid dynamics technology to evaluate the influence of the degree of hydronephrosis on the kidneys’ ability to discharge the stones. Methods Using the related literature, we combined the morphological characteristics and measurement data of the normal renal pelvis and calyx at different degrees of hydronephrosis and drew Model A (branched pelvis group), Model B (mature ampullary pelvis group), and Model C (embryo pot abdominal pelvis group) using the CAD software. The ICEM CFD software was used to create a mesh in each model and Fluent 17.0 was used to perform hydromechanical analysis for the meshed models. In order to obtain a visualized image of the hydrodynamic parameters of each model, the Tecplot 360 software was used, which post-processed and visualized the Fluent simulation results. Data were analyzed using SPSS 17.0 software. Results In the group A model, the flow velocity at the outlet and the neck of the calyces, and the outlet of the renal pelvis was A1> A2> A3> A4 (P <0.05). Similarly, in the group B model, the flow velocity at the outlet and the neck of the calyces, and the renal pelvis was B1> B2> B3> B4 (P <0.05). In the C group model, the flow velocity at the outlet of the calyces and the renal pelvis was C1> C2> C3> C4 (P <0.05). In the groups, A1, B1, and C1, the flow rate of urine in the neck of renal calyx were compared in pairs (P> 0.05) and was found to be greater in group A1 compared to the group B1 (P <0.05). There was no significant difference in urine flow rate at the outlet of the renal pelvis between the groups A1 and B1 (P> 0.05), while the flow rate of urine in the C1 group was greater than both A1 and B1 groups (P <0.05). The circulatory stagnation zone at the entrance of renal calyces in the group A1 was the smallest, whereas it gradually increased in the groups A2, A3, and A4. Also, due to the gradual decrease of the urine velocity gradient in the four model groups, the urine flow at the edge was increasingly affected by the wall of the tube, eventually thickening its velocity boundary layer. Conclusion Hydronephrosis can cause changes in the urodynamics of urine. As the degree of hydronephrosis increases, the flow velocity of urine at the neck of the kidney, the outlet of the renal pelvis, the urinary shearing force of the stones, and the kidney’s ability to discharge the stones gradually decreases, whereas the circulatory stagnation zone and the velocity boundary layer in the kidney aggregate system gradually increases. Therefore, the effect of different degrees of hydronephrosis on the patient’s ability to discharge stones after surgery should be fully considered to choose an appropriate treatment method for kidney stones in the clinic.

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History
  • Received:December 14,2020
  • Revised:February 07,2021
  • Adopted:February 18,2021
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