A Numerical Study to Precise the Estimation of the “Good” Mound Height in Endoscopic Treatment of VUR

Abstract

Objective: To ascertain the technique and volume of injection increasing the success rate of endoscopic VUR treatment, we develop a novel method to numerically describe the relationship between intramural ureter anatomy, intravesical pressure, and the theoretical mound height needed for adequate treatment. Methods: The main purpose of this study is to construct a finite element simulation of intramural ureter and injected mound which aims to numerically define the relationship between indexes which have influence in VUR endoscopic treatment. Using linearization software and numerically simulation data, the relationship between effective indexes has been derived. Results: By linearization of the effective parameters of different finite element models, the relationship bet ween effective parameters in filling phase is derived as: H (m ) = ﹣ 0.0 034 67 (m) + 0.7864 D (m) + 0.000233. This equation depicts adequate injected mound height as a function of internal diameter and intramural length, H = f ( L , D ). Conclusion: Using numerical simulation, we introduced the novel formula to predict the height of injected mound in endoscopic VUR treatment. As a result of this study, in order to increasing the success rate of this treatment, the ratio of mound height to intramural ureter diameter should be approximately 78%.