Does ureteral access sheath affect the outcomes of retrograde intrarenal surgery: a prospective study

2021 ◽  
pp. 1-5
Author(s):  
Erman Damar ◽  
Cagri Senocak ◽  
Ridvan Ozbek ◽  
Hakan Bahadir Haberal ◽  
Fahri Erkan Sadioglu ◽  
...  
Keyword(s):  
Prospective Study ◽  
Retrograde Intrarenal Surgery ◽  
Ureteral Access Sheath ◽  
Access Sheath ◽  
A Prospective Study

A Prospective Study Analyzing the Association Between High-grade Ureteral Access Sheath Injuries and the Formation of Ureteral Strictures

Urology ◽  
2019 ◽  
Vol 128 ◽  
pp. 38-41 ◽  
Author(s):  
Karen L. Stern ◽  
Christopher J. Loftus ◽  
Steeve Doizi ◽  
Olivier Traxer ◽  
Manoj Monga
Keyword(s):  
Prospective Study ◽  
High Grade ◽  
Ureteral Access Sheath ◽  
Access Sheath ◽  
A Prospective Study

scholarly journals Semirigid ureteroscopy prior retrograde intrarenal surgery (RIRS) helps to select the right ureteral access sheath

2018 ◽  
Vol 90 (1) ◽  
pp. 20 ◽  
Author(s):  
Ioannis Boulalas ◽  
Mauro De Dominicis ◽  
Lorenzo Defidio
Keyword(s):  
Retrograde Intrarenal Surgery ◽  
Ureteral Access Sheath ◽  
Access Sheath ◽  
Ureteral Lithiasis ◽  
Ureteral Injuries ◽  
The Right ◽  
A Prospective Study ◽  
Correlated Factors ◽  
Disease Location ◽  
Selection Of

Objective: To evaluate ureteral compliance through semirigid ureteroscopy (sURS) in order to select the proper ureteral access sheath (UAS) size for retrograde intrarenal surgery (RIRS). Patients and methods: In a prospective study, 100 consecutive patients selected for elective sURS or RIRS were recruited. Each patient, initially underwent 9.5 Fr sURS with a safety guidewire 3Fr, in order to estimate ureteral compliance. If the ureter was compliant, a gently passage of a 12/14Fr UAS was attempted. If the ureter was not deemed compliant, passage of either a smaller UAS or a smaller semirigid 7Fr or a flexible 7.5Fr or a digital 8.5Fr scope with and without safety guidewire, was attempted. Age, gender, disease location, prestenting, previous RIRS and/or stone elimination, hydronephrosis, ureteral strictures, unsuccessful procedures, and complications, were analyzed as possible correlated factors of ureteral compliance. Results: In 77 patients the ureter was deemed compliant ≥ 14Fr. Of the preoperative factors that were examined, stent placement before RIRS (P < 0.002), previous RIRS (P = 0.000) and previous stone elimination (P = 0.004), correlated with ureter ≥ 14Fr. Ureteral lithiasis (P < 0.001), ureteral strictures (P < 0.05), unsuccessful procedures (P < 0.005) and complications (P = 0.01) correlated with ureter < 14Fr. The complication rate was 10% (10 patients) with ureteral injuries grade I in 9 patients and grade III in 1 patient according to the endoscopic grading system. Age, gender, hydronephrosis and urothelial carcinoma (UC) had no influence. Conclusions: sURS performed before RIRS allows selection of the right ureteral access sheath (UAS) and avoidance of major complications. Pre-stenting, previous RIRS and stone elimination history are all factors correlating with a compliant ureter.

scholarly journals Pre-stenting for Retrograde Intrarenal Surgery: Need and Duration: a Prospective Randomized Clinical Study

2020 ◽  
Vol 3 (2) ◽  
pp. 361-365
Author(s):  
Prakash Chhettri ◽  
Anil Shrestha ◽  
Robin Bahadur Basnet ◽  
Parash Mani Shrestha
Keyword(s):  
Controlled Study ◽  
Retrograde Intrarenal Surgery ◽  
Ureteral Access Sheath ◽  
Access Sheath ◽  
Randomized Clinical Study ◽  
Institutional Review ◽  
Group 3 ◽  
Group 2 ◽  
Wall Injury ◽  
Group 1

Introduction: To evaluate if retrograde intrarenal surgery with ureteral access sheath requires prestenting. In case pre-stenting becomes an option, how long does it need to be stented.  Materials and Methods: After obtaining approval from Institutional Review Board and informed consent, a prospective randomized controlled study was conducted in the Department of Urology, Bir Hospital for 18 months. All the patients enrolled for retrograde intrarenal surgery were grouped into 3 groups: Group 1 – without pre-stenting, Group 2 – one week of pre-stenting, and Group 3 – two weeks of pre-stenting. Success was defi ned as an ability to accommodate a 10/12 F ureteral access sheath during retrograde intrarenal surgery. Ureteral access sheath induced ureteric wall injury was also taken into consideration.Results: Among 179 cases, 152 cases were included in the study. In 36 patients out of 53 (67.92%) in group 1, 10/12 F ureteral access sheath was negotiable without pre-stenting, marking the frequency of distensible ureters. In 44 patients out of 47 (93.66%) from group 2 and all 52 patients (100%) from group 3, ureteral access sheath placement was successful after one and two weeks of pre-stenting respectively. Ureteric wall injury of grade1 and 2, was found in 9 patients (5.9%).Conclusions: The majority of ureters (67.92%) are distensible, not requiring pre-stenting before retrograde intrarenal surgery. One and two weeks of pre-stenting carries a success rate of 93.66% and 100% respectively.

Effects of ureteral access sheath use on postoperative infection in retrograde intrarenal surgery

2019 ◽  
Vol 18 (2) ◽  
pp. e2384-e2385
Author(s):  
M. Karaaslan ◽  
S. Tonyali ◽  
M. Yilmaz ◽  
E. Olcucuoglu ◽  
S. Tastemur
Keyword(s):  
Postoperative Infection ◽  
Retrograde Intrarenal Surgery ◽  
Ureteral Access Sheath ◽  
Access Sheath

S163 Should ureteral access sheath during retrograde intrarenal surgery be placed routinely?

2013 ◽  
Vol 12 (4) ◽  
pp. e1271, S163
Author(s):  
E. Ozyuvali ◽  
U. Oguz ◽  
E. Damar ◽  
M. Yildirim ◽  
Y. Yildiz ◽  
...  
Keyword(s):  
Retrograde Intrarenal Surgery ◽  
Ureteral Access Sheath ◽  
Access Sheath

scholarly journals An Early Experience of Retrograde Intrarenal Surgery (RIRS) in National Institute of Kidney Diseases and Urology

2020 ◽  
Vol 23 (1) ◽  
pp. 3-10
Author(s):  
Md Nasir Uddin ◽  
Imtiaz Enayetullah ◽  
Kazi Zikrur Razzaque ◽  
Sharif Md Shahadat Ali Khan ◽  
Kazi Rafiqul Abedin
Keyword(s):  
Statistical Analysis ◽  
Blood Transfusion ◽  
Hospital Stay ◽  
Kidney Diseases ◽  
Operation Time ◽  
Renal Stones ◽  
Retrograde Intrarenal Surgery ◽  
Ureteral Access Sheath ◽  
Access Sheath ◽  
The Mean

Background: Advancements in the endoscopic armamentarium, retrograde intrarenal surgery has become a viable and attractive option for the treatment of renal stones because of its high stone-free rates (SFRs) and low morbidity. Objective: To describe our experience and outcome of RIRS for the treatment of renal stones and to assess its effectiveness and safety. Design, setting, and participants: A retrospective analysis of 60 patients who underwent RIRS for renal stones at our institute between January 2018 to December 2018 was performed. Surgical procedure: Flexible ureteroscopy and laser lithotripsy using a standardized technique with last-generation flexible ureteroscopes (Flex-Xc) using Holmium-YAG laser. Outcome measurements and statistical analysis: Clinical data were collected and intraoperative and postoperative outcomes were assessed (Ureteral access sheath placement, operation time, hospital stay, stone free rate, post-operative blood transfusion & fever, need for second session of RIRS. A descriptive statistical analysis was performed. Results and limitations: The mean overall stone size was 13±3 mm. Pre stenting done in all cases. Ureteral access sheath placement was possible in 54(90%) patients. At 1 month follow-up, the overall primary SFR was 86.67%(52 cases), the secondary SFR was 96.67%(58 cases).The mean operative time was 91.96±18.7 min. Mean hospital stay was 1.86±1.02 days. Complications were reported in 8 (13.33%) patients overall, with fever in 6 patients (10%), steinstrasse in 2(3.33%) patients need for second session RIRS in 6 patients (10%).No patient needed blood transfusion. The main limitation of the study is the retrospective nature. Conclusions: RIRS performed using a flexible ureterorenoscope marked the beginning of a new era in urology. It is safe and effective procedure and an alternative to extracorporeal shock wave lithotripsy (ESWL) and Percutaneous nephrolithotomy (PCNL) in the treatment of selected renal stones. Bangladesh Journal of Urology, Vol. 23, No. 1, January 2020 p.3-10

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