BRIEF RESEARCH REPORT article
Front. Urol.
Sec. Pediatric, Adolescent and Developmental Urology
Volume 5 - 2025 | doi: 10.3389/fruro.2025.1634278
Novel modality using computational fluid dynamics to estimate renal pelvis pressure and evaluate severity of obstruction in congenital hydronephrosis
Provisionally accepted
Kenichi Nishimura1*
Syuta Imada2Naoya Sugihara1Tetsuya Fukumoto1Noriyoshi Miura1Yuki Miyauchi1Tadahiko Kikugawa1Masanori Nakamura2Takashi Saika1- 1Ehime Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Toon, Japan
- 2Nagoya Kogyo Daigaku, Nagoya, Japan
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Congenital hydronephrosis involves obstruction of the ureteropelvic junction, which impairs urine passage and elevates renal pelvic pressure. Elevated renal pelvic pressure detrimentally affects renal function. Pyeloplasty is a surgical procedure that aims to prevent deterioration of renal function. The Whitaker test, which is conducted using nephrostomy, is used to measure renal pelvic pressure. However, this method is highly invasive, highlighting the need for alternative testing approaches. Computational fluid dynamics (CFD) provides quantitative predictions of fluid flow phenomena and has recently been applied in medicine. Objective: The aim of this study was to develop an evaluation method using computational fluid dynamics (CFD) to determine pyeloplasty indications. Methods: The CFD were analyzed using computed-tomography-extracted images. The urine flow in the extracted geometry was simulated by solving the continuity and Navier–Stokes equations. Key Findings and Limitations: CFD analysis revealed that renal pelvic pressure increases when urine output increases because of ureteropelvic junction obstruction during hydronephrosis. Furthermore, hydronephrosis with a renal pelvic pressure of 0.015–0.086 Pa, within the physiological urine output range of 360–1440 mL/day, was associated with poor renal function. The main limitation of this method is that the intrarenal pressure analyzed using CFD is an estimate and not the actual pressure. Conclusions and Clinical Implications: Thus, renal-pelvic pressure can be measured through CFD analysis. Furthermore, CFD analysis can be used as a new modality to determine severity of obstruction.
Keywords: Hydronephrosis, renal pelvic pressure, pyeloplasty, Urine output, Surgical indications
Received: 24 May 2025; Accepted: 25 Aug 2025.
Copyright: © 2025 Nishimura, Imada, Sugihara, Fukumoto, Miura, Miyauchi, Kikugawa, Nakamura and Saika. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kenichi Nishimura, Ehime Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Toon, Japan
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.