[Pay much attention to control and manage the high pressure of renal plevic and the backflow of irrigation during the operation of urolithiasis of upper tract urinary].

Endoscopic surgery has become the most common urological procedure for calculus in upper urinary tract. However, the widespread usage of minimally invasive endoscopic techniques failed to end the occurrence of perioperative complications, especially some fatal complications. The most severe complication of urolithiasis related endoscopic procedure is urosepsis, which is closely related to the backflow of irrigation fluid induced by the high pressure of renal pelvic during the procedure. By controlling the perfusion and drainage during the operation, the liquid backflow can be reduced effectively, thus may reduce the spread of infectious toxins and pathogens, and incidence of infectious complications can be controlled accordingly. In this article, the pathophysiology of urinary obstruction, the backflow which caused by elevated renal pelvic pressure and its subsequent pathophysiological changes, the control of intra-renal gressure and the prevention of urosepsis will be reviewed. The important range of intra-renal pressure and the major steps for pressure control during the operation is emphasized.