First Prospective, In Vivo Experience Using a Novel Steerable Suction Ureteral Access Sheath in North America

To report the first prospective, in-vivo, single-center experience using the ClearPetra UAS, a novel flexible and navigable suction (FANS), in North America.

We prospectively enrolled 87 consecutive patients who required flexible ureteroscopy with UAS placement for renal stone treatment. The ClearPetra UAS was employed in place of traditional UAS. Patients with a history of recurrent urinary tract infections or positive preoperative urine culture were excluded. Baseline characteristics, intra- and postoperative outcomes were recorded. Stone volumes were measured using non-contrast CT (NCCT) and a semiautomated segmentation program (qSAS).

Of 87 patients, 58 had multiple stones and 11 required bilateral ureteroscopy for a total of 98 renal units with mean preoperative stone volume of 473.7 mm³. The ClearPetra UAS was used successfully in all patients despite only 31% being pre-stented. Only 12 cases required a basket. There were 9 ureteral injuries-8 Traxer Grade 1-2 and 1 Grade 3. Forty-two patients were eligible for volumetric analysis. Stone volume reduction was 89.8%.

This is the first reported series of patients in North America to undergo ureteroscopy using a ClearPetra UAS and is unique in its inclusion of aberrant anatomy. The sheath was safe and effective with acceptable postoperative complication rates and stone-free status.