Novel everting urologic access sheath: decreased axial forces during insertion

Area of Science:

• Urology
• Biomedical Engineering
• Medical Device Innovation

Background:

• Urologic instrument advancement generates significant axial forces, causing patient discomfort and potential trauma.
• These forces can lead to mucosal damage, dysuria, hematuria, infection, and strictures.
• An everting urethral sheath may mitigate these adverse effects.

Purpose of the Study:

• To evaluate the efficacy of a novel everting urethral sheath in reducing axial forces during urologic procedures.
• To compare the force reduction capabilities of the everting sheath against traditional methods.

Main Methods:

• Two urethral luminal models (7-cm long, 5-mm diameter) were created, one with an artificial stricture.
• Axial forces were measured during the advancement of a novel everting access sheath (Cystoglide) and compared to a cystoscope and a traditional access sheath.
• Tests were conducted with and without lubrication and with and without an artificial stricture.

Main Results:

• The everting sheath generated significantly lower mean advancement forces compared to both the cystoscope (P<0.01) and the traditional access sheath (P<0.01).
• This force reduction was consistent in models with and without artificial strictures (P<0.01).
• Lubrication also did not significantly alter the force reduction benefit of the everting sheath (P<0.01).

Conclusions:

• The novel everting introduction sheath substantially decreased axial forces on the urethral luminal wall.
• Clinical application of this technology holds potential for reducing discomfort and complications in lower urinary tract endoscopy.