Optimizing RIRS in Complex Renal Anatomy: A Comparative study of Tip-Flexible Suction versus Conventional Ureteral...

Area of Science:

• Urology
• Endourology
• Nephrology

Background:

• Congenital renal anomalies present unique challenges for kidney stone management.
• Standard ureteral access and pressure management are difficult in these complex anatomies.
• Suction-assisted ureteral access sheaths (UAS) offer a potential solution, but data are limited.

Purpose of the Study:

• To evaluate the efficacy of tip-flexible suction UAS in retrograde intrarenal surgery (RIRS) for patients with congenital renal anomalies.
• To compare outcomes between suction-assisted UAS and conventional UAS in this patient population.

Main Methods:

• Retrospective review of 67 patients with renal anomalies and 2-4 cm stones undergoing RIRS.
• Patients were grouped by UAS type: suction-assisted (TFS-UAS) or conventional (T-UAS).
• Surgical and postoperative outcomes including stone-free rate (SFR), operative time, complications, and hospital stay were compared.

Main Results:

• The suction-assisted UAS group had a higher 30-day SFR (94.3%) versus conventional UAS (81.3%).
• Operative time was significantly longer with suction-assisted UAS (p < 0.001).
• Hospital stay was significantly shorter with suction-assisted UAS (p = 0.003), with no major difference in complication rates.

Conclusions:

• Suction-assisted UAS offers clinical benefits for RIRS in patients with congenital renal anomalies.
• This technique may improve stone fragment removal and facilitate easier recovery.
• The advantages of improved success rates and recovery often outweigh the increased procedural time.