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Ureteral access sheaths in RIRS: a retrospective, comparative, single-center study

  • Giuseppe Celentano , Biagio Barone ORCID logo EMAIL logo , Roberto La Rocca , Matteo Massanova , Luigi Napolitano , Domenico Prezioso , Marco Abate , Benito Fabio Mirto , Ferdinando Fusco and Felice Crocetto
Published/Copyright: September 20, 2024
Journal of Basic and Clinical Physiology and Pharmacology
From the journal Journal of Basic and Clinical Physiology and Pharmacology Volume 35 Issue 4-5

Abstract

Objectives

To evaluate the use of ureteral access sheaths (UAS) in reducing operative time and complications, as well as improving stone-free rates (SFR), while assessing their overall safety and efficiency.

Methods

Data regarding 234 patients who underwent retrograde intrarenal surgery (RIRS) for stones up to 3 cm between January 2017 and March 2020 were retrospectively analyzed. About 52.5 % of procedures were performed utilizing a UAS. Differences in operative time, fluoroscopy time, stone-free rate, and complications were analyzed between procedures with and without UAS and stratified, according to stone burden size, into three groups (Group A: 0.5–1 cm; Group B: 1–2 cm; Group C: 2–3 cm).

Results

Operative time, fluoroscopy time, and residual fragments size were lower in RIRS without UAS, respectively, 54.27 ± 24.02 vs. 62.23 ± 22.66 min (p=0.010), 2.72 ± 0.89 vs. 4.44 ± 1.67 min (p<0.0001), and 3.85 ± 0.813 vs. 4.60 ± 0.83 mm (p=0.011). Considering stone burden, operative time was lower in RIRS without UAS for Group A (36.40 ± 8.555 vs. 46.05 ± 6.332 min) (p<0.0001) while higher for Group B (60.39 ± 18.785 vs. 50.14 ± 5.812 min) (p=0.002). Similarly, fluoroscopy time was lower in RIRS without UAS in every group, respectively, 2.11 ± 0.34 vs. 2.74 ± 0.57 min (p<0.0001), 2.94 ± 0.51 vs. 4.72 ± 0.37 min (p<0.0001), and 3.78 ± 1.26 vs. 6.79 ± 1.17 min (p<0.0001). Only Group C had a statistically significant difference in residual fragment size without UAS (3.89 ± 0.782 vs. 4.75 ± 0.886 mm) (p=0.050).

Conclusions

UAS should be carefully evaluated considering the increased fluoroscopy time and the differences in operative time related to different stone burdens.

Keywords: RIRS; stone-free rate; ureteral access sheath
Corresponding author: Biagio Barone, Department of Urology, Ospedale San Paolo, ASL NA1 Centro, 80125 Naples, Italy, E-mail:
Giuseppe Celentano, Biagio Barone, and Felice Crocetto contributed equally to this work.

  1. Research ethics: Not applicable.

  2. Informed consent: Not applicable.

  3. Use of Large Language Models, AI and Machine Learning Tools: None declared.

  4. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  5. Use of Large Language Models, AI and Machine Learning Tools: None declared.

  6. Conflict of interest: All other authors state no conflict of interest.

  7. Research funding: None declared.

  8. Data availability: Not applicable.

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Received: 2024-08-04
Accepted: 2024-08-29
Published Online: 2024-09-20

© 2024 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/jbcpp-2024-0142
Keywords for this article
RIRS; stone-free rate; ureteral access sheath

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. Targeting Rho GTPase regulators in cancer: are we hitting the mark?
  4. The pitfalls of linear regression in physiological research
  5. Reviews
  6. Lipid profile and mortality in patients with pulmonary thromboembolism; a systematic review and meta-analysis
  7. IcoSema: unveiling the future of diabetes management from a clinical pharmacology perspective
  8. Deucravacitinib: moderate-to-severe plaque psoriasis preventable?
  9. The key roles of thyroid hormone in mitochondrial regulation, at interface of human health and disease
  10. Uncovering the coronavirus outbreak: present understanding and future research paths
  11. Effects of thyroid hormones in skeletal muscle protein turnover
  12. Original Articles
  13. Effect of high-intensity interval training vs. moderate-intensity continuous training on cardiometabolic risk factors in overweight and obese individuals
  14. Alcohol promotes liver fibrosis in high fat diet induced diabetic rats
  15. Association between aerobic performance and physiological responses in Yo-Yo intermittent recovery test level 2, and the futsal-specific intermittent endurance test in trained futsal players
  16. Oral vs. injected: which vitamin D boost works best for low levels?
  17. Effects of an 8-week intervention of anulom vilom pranayama combined with heartfulness meditation on psychological stress, autonomic function, inflammatory biomarkers, and oxidative stress in healthcare workers during COVID-19 pandemic: a randomized controlled trial
  18. Ureteral access sheaths in RIRS: a retrospective, comparative, single-center study
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