Ureteral access sheath use in retrograde intrarenal surgery

  • Mustafa Karaaslan University of Health Sciences, Turkiye Yuksek Ihtisas Training and Research Hospital, Clinic of Urology, Ankara, Turkey.
  • Senol Tonyali | senoltonyali@hotmail.com University of Health Sciences, Turkiye Yuksek Ihtisas Training and Research Hospital, Clinic of Urology, Ankara, Turkey.
  • Mehmet Yilmaz University of Health Sciences, Turkiye Yuksek Ihtisas Training and Research Hospital, Clinic of Urology, Ankara, Turkey.
  • Sedat Yahsi University of Health Sciences, Turkiye Yuksek Ihtisas Training and Research Hospital, Clinic of Urology, Ankara, Turkey.
  • Sedat Tastemur University of Health Sciences, Turkiye Yuksek Ihtisas Training and Research Hospital, Clinic of Urology, Ankara, Turkey.
  • Erkan Olcucuoglu University of Health Sciences, Turkiye Yuksek Ihtisas Training and Research Hospital, Clinic of Urology, Ankara, Turkey.

Abstract

Objective: To determine if there is a difference between postoperative urinary infection rates after retrograde intra-renal surgery (RIRS) when ureteral access sheath (UAS) was used or not used.
Materials and methods: We retrospectively analyzed the medical records of all patients who underwent RIRS at our institution between January 2016 and October 2018.
Results: 129 patients were included in the study. The mean age of the patients was 48.8 ± 12.1 years; 94 patients were male and 35 were female. The mean stone size (largest diameter), stone attenuation and stone volume were 15.3 ± 5.8 mm, 1038 ± 368 HU and 1098 ± 1031 mm3, respectively. Out of 129 patients, 81 were treated by using UAS (Group 1) and 48 were treated without use of UAS (Group 2). There was no statistically significant difference between the two groups in terms of post-operative infection (p = 0.608). However, the operative time of patients with post-operative infection was statistically higher than the other patients; 88.35 ± 22.5 min versus 59.37 ± 22.1 min (p = 0.017). In multivariate regression analysis, operation time (p = 0.02, r = 1.07) was found to be the sole predictor of post-operative infection.
Conclusions: Using UAS during RIRS might reduce the intrarenal pressure and also has several advantages. However not prolonging the operation time too much could be of higher importance than UAS use in terms of preventing post-operative infection after RIRS.

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Published
2019-07-02
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Issue
Section
Original Papers - Stones and Infections
Keywords:
Nephrolithiasis, Sepsis, Ureteral access sheath, Intrarenal pressure
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How to Cite
Karaaslan, M., Tonyali, S., Yilmaz, M., Yahsi, S., Tastemur, S., & Olcucuoglu, E. (2019). Ureteral access sheath use in retrograde intrarenal surgery. Archivio Italiano Di Urologia E Andrologia, 91(2). https://doi.org/10.4081/aiua.2019.2.112