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The Role of 12/14F Ureteral Access Sheath in Flexible Ureteroscopy for Moderate Nephrolithiasis

Tomasz Ozimek1, Pauline Dellas1, Benedikt Becker2

  • 1Klinik für Urologie, Universitätsklinikum Schleswig-Holstein Campus Lübeck, Lübeck, Germany.

Aktuelle Urologie
|March 14, 2023
PubMed

Insights

This study found no significant benefits of using ureteral access sheaths (UAS) for moderate nephrolithiasis (MN) during flexible ureteroscopy. Both with and without UAS strategies are feasible for kidney stone treatment.

Area of Science:

  • Urology
  • Endourology
  • Nephrolithiasis Management

Background:

  • Moderate nephrolithiasis (MN) involves unilateral kidney stones (max 2, diameter 6-10 mm).
  • Ureteral access sheath (UAS) usage is common in urological procedures.

Purpose of the Study:

  • To retrospectively analyze the impact of 12/14F UAS on perioperative outcomes in MN patients.
  • To evaluate the efficacy and safety of UAS in flexible ureteroscopy (fURS) for MN.

Main Methods:

  • Monocentric retrospective analysis of fURS for MN (01/2014-12/2018).
  • Comparison of outcomes between patients treated with and without UAS.
  • Univariate and multivariate analyses were performed.

Main Results:

  • UAS was used in 29.46% of 112 MN cases.
  • Univariate analysis showed longer operation and fluoroscopy times with UAS, but these were not significant in multivariate analysis.
  • UAS did not improve stone-free rates or reduce complications (Clavien-Dindo ≥2) or hospital stay.

Conclusions:

  • No statistical benefits were identified for using 12/14F UAS in MN.
  • No relevant UAS-associated complications were observed.
  • Both strategies (with and without UAS) are feasible for MN treatment.

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