Introduction: The rate of success of retro-
grade intrarenal surgery (RIRS) for treating
urinary tract stones is high, and the procedure is growing in
popularity. The routine use of ureteral access sheath (UAS)
remains somewhat controversial. The aim of this study was to
assess the efficacy and safety of employing UAS during flexible
ureteroscopy for treating renal stones ≥ 2 cm.
Methods: This retrospective study was accomplished from
January 2021 to February 2023. From 495 consecutives flexible
ureteroscopies, 112 patients had renal stones ≥ 2 cm (60
patients with the use of UAS and 52 patients without). The
stone-free status was verified after 8 weeks of operation.
Results: The average diameter of the renal stones in non-UAS or
UAS treated groups was 22.5 mm and 22.6, respectively. None
of the groups differed significantly in terms of stone side, stone
size, stone position, or Hounsfield unite but there was significant
difference (p < 0.001) among two groups as regard pre-opera-
tive stenting (cases with UAS had 23.3% pre-operative stenting).
Conclusions: It is not always necessary to use UAS in conjunc-
tion with flexible ureteroscopy and laser lithotripsy to treat
renal calculi bigger than or equal two cm. Without the assis-
tance of UAS, the surgery may be carried out successfully and
safely. |
