https://doi.org/10.4081/aiua.2023.11149

Comparison of commonly utilized ureteral access sheaths: A prospective randomized trial

Vol. 95 No. 2 (2023)
Submitted: January 11, 2023
Accepted: January 22, 2023
Published: June 5, 2023
Ureteroscopy, Urolithiasis, Ureteral Access sheath, Ureteral trauma
Abstract Views: 864
PDF: 512
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Authors

Mohamed Elsaqa
mohamed.elsaqa@alexmed.edu.eg
https://orcid.org/0000-0003-3341-3648
Alexandria University Faculty of Medicine, Alexandria, Egypt; Baylor Scott & White Medical Center, Temple, TX, United States.
Zain Hyder
https://orcid.org/0000-0002-5521-9558
Baylor Scott & White Medical Center, Temple, TX, United States.
Kim Thai
Baylor Scott & White Medical Center, Temple, TX, United States.
Katherine Dowd
Baylor Scott & White Medical Center, Temple, TX, United States.
Amr El Mekresh
Baylor Scott & White Medical Center, Temple, TX, United States.
Kristofer Wagner
Baylor Scott & White Medical Center, Temple, TX, United States.
Belur Patel
Baylor Scott & White Medical Center, Temple, TX, United States.
Patrick Lowry
https://orcid.org/0000-0003-0806-7413
Baylor Scott & White Medical Center, Temple, TX, United States.
Marawan M. El Tayeb
https://orcid.org/0000-0002-4703-2953
Baylor Scott & White Medical Center, Temple, TX, United States.

Objective: We aimed to evaluate and compare the functional characteristics, safety profile and effectiveness of two commonly used ureteral access sheaths (UAS) during flexible ureteroscopy. Methods: After institutional review board approval, patients with proximal ureteral or kidney stones requiring flexible ureteroscopy and UAS were prospectively randomized to group I or group II according to the type of access sheath used. Primary outcome was incidence of intraoperative complications. Results: Eighty-eight patients were enrolled in the study, 44 patients in each group. Sheath size 12/14 FR was used in both cohorts. Median (IQR) stone size was 10 mm (7-13.5) and 10.5 mm (7.37-14) in group I and II respectively (p = 0.915). Nineteen and twenty patients, in group I and II respectively, were pre-stented. Subjective resistance with insertion of the UAS was observed in 9 and 11 patients in group I and II respectively (p = 0.61) while failed insertion was encountered in one patient in group I. Traxer grade 1 ureteral injury was noted in 5 and 6 patients in group I and II respectively while grade 3 injury was seen in 1 patient for both cohorts (p = 0.338). There was less resistance for UAS placement in pre-stented patients (p = 0.0202) but without significant difference in ureteric injury incidence (p = 0.175). Emergency department visits were encountered in 7 (group I) and 5 patients (group II) (p = 0.534). Conclusions: The studied UASs were comparable regarding safety and efficacy in the current study. Pre-stented and dilated ureters had less resistance to insertion although this was not reflected on incidence of ureteric injury.

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How to Cite

Elsaqa, M., Hyder, Z., Thai, K., Dowd, K., El Mekresh, A., Wagner, K., Patel, B., Lowry, P., & El Tayeb, M. M. (2023). Comparison of commonly utilized ureteral access sheaths: A prospective randomized trial. Archivio Italiano Di Urologia E Andrologia, 95(2). https://doi.org/10.4081/aiua.2023.11149
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