Urology Journal

ISSN: 1735-1308

March-April 2022
Vol. 19 No. 02 (2022)

Is 10/12 Fr Ureteral Access Sheath more Suitable for Flexible Ureteroscopic Lithotripsy?

Urology Journal, Vol. 19 No. 02 (2022), , Page 89-94
https://doi.org/10.22037/uj.v18i.6620

Abstract

Purpose: To choose the ideal ureteral access sheath (UAS) size for an unstented ureter in flexible ureteroscopic
lithotripsy (FURL).
Materials and Methods: A retrospective study was conducted in patients treated with FURL for renal calculi from 2005 to 2020. The patients were divided into two groups: smaller (10/12 Fr) vs. larger (12/14 Fr) calibre UAS. The outcomes were the insertion success rate, systemic inflammatory response syndrome (SIRS) complication rate after the operation, ureteral wall injury, operative time, and stone-free rate.
Results: Of the 1573 patients enrolled, 10/12 Fr UAS was used in 957 patients (Group A), and 12/14 Fr UAS was
used in the remaining patients (Group B). The insertion success rate was significantly better in Group A (91.2%
vs. 86.9%, P = .006), with no significant difference between the groups regarding the stone-free rate, postoperative pain, operative time or hospital stay. The severity of visible ureteral lesions with 10/12 Fr UAS was significantly lower than that with larger UASs (80.1% vs 85.2%, P < .001). Despite the lack of a significant difference in the incidence of SIRS between the two groups, the incidence of SIRS in the 10/12 Fr group showed a sharp increase with stones > 2 cm (17.0% vs. 8.5%, P = 0.037).
Conclusion: The use of 10/12 Fr UAS was beneficial with respect to insertion success rate, avoiding ureteral wall
injury and not increasing postoperative infectious complications in FURL. We recommend the use of a smaller
calibre (10/12 Fr) UAS in patients with renal calculi < 2 cm.

Keywords:
  • Ureteroscopy
  • Ureter
  • Lithotripsy
  • Ureteral access sheath
  • Infectious complications

How to Cite

Li, W., Mao, Y., Gu, Y., Lu, C., Gu, X., Hua, B., Pan, W., Xi, Q., & Wang, Z. (2021). Is 10/12 Fr Ureteral Access Sheath more Suitable for Flexible Ureteroscopic Lithotripsy?. Urology Journal, 19(02), 89-94. https://doi.org/10.22037/uj.v18i.6620

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