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Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
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IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
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Updated: Oct 1, 2025

Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
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Flexible ureteroscopy without ureteral access sheath.

C Cristallo1, D Santillán1, I Tobia1

  • 1Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Actas Urologicas Espanolas
|March 9, 2022
PubMed
Summary
This summary is machine-generated.

Flexible ureteroscopy and laser lithotripsy (FURS) without a ureteral access sheath (UAS) is as safe as with a UAS, but offers shorter operative times and fewer ancillary procedures. This suggests UAS may not be necessary in all FURS cases.

Keywords:
Cirugía intrarrenal retrógradaCálculos renalesEndourologyEndourologíaKidney stonesRetrograde intrarenal surgeryUreteral access sheathVaina de acceso ureteral

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Area of Science:

  • Urology
  • Endourology
  • Nephrolithiasis Management

Background:

  • Ureteral access sheath (UAS) use in flexible ureteroscopy and laser lithotripsy (FURS) is common for improved stone clearance and reduced intrarenal pressure.
  • However, UAS can increase surgical costs and potentially cause ureteral injury.

Purpose of the Study:

  • To compare the safety and efficacy of FURS with and without UAS.
  • To determine if UAS is justified in all FURS procedures for upper ureter and renal stones.

Main Methods:

  • Retrospective observational study of 241 patients undergoing FURS for upper ureter and renal stones.
  • Patients were divided into two groups: those who received UAS and those who did not.
  • Comparison of demographic data, stone characteristics, operative time, and postoperative outcomes including infection, pain, and need for further procedures.

Main Results:

  • 198 patients (82.2%) were treated without UAS.
  • Operative time was significantly shorter in the no-UAS group (64.6 min vs. 89.9 min; p=0.010).
  • Ancillary procedures were more frequent in the UAS group (37.2% vs. 21.2%; p=0.026), though this lost significance in multivariate analysis. Rates of colic pain and UTI were similar between groups.

Conclusions:

  • FURS without UAS is as safe as FURS with UAS.
  • FURS without UAS requires fewer ancillary procedures and has a shorter operative time.
  • The routine use of UAS in FURS may not be necessary for all patients.