Comparison of Flexible and Navigable Suction Versus Conventional Ureteral Sheath in Retrograde Intrarenal Surgery: A Randomized Controlled Prospective RIRSearch Group Study.
Mehmet Fatih Şahin, Çağrı Doğan, Kerem Teke et al.
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In 30 seconds
This seven-centre prospective randomised controlled study compared flexible and navigable suction ureteral access sheaths (FANS-UAS) with conventional sheaths (CUAS) during retrograde intrarenal surgery in 161 patients. At one month, stone-free rate was higher with FANS-UAS than CUAS (79.3% vs 63.3%, p = 0.041). CUAS procedures were shorter, while perioperative bleeding was more frequent with FANS-UAS. Postoperative complication rates did not differ significantly. The findings suggest a trade-off between improved stone clearance and longer operating time and greater perioperative bleeding with the suction sheath.
Key findings
- One-month stone-free rate was 79.3% with FANS-UAS versus 63.3% with CUAS (p = 0.041).
- Operative time was shorter in the CUAS group (p = 0.011).
- Perioperative bleeding was higher with FANS-UAS (p = 0.034), without a significant difference in postoperative hemoglobin decrease.
- Postoperative complications did not differ significantly between groups (p = 0.162).
Why it matters
The results highlight a potential procedural trade-off in RIRS: the suction sheath was associated with better short-term stone-free rates, but also longer procedures and more perioperative bleeding. These outcomes can inform evaluation of access-sheath options, while the absence of a difference in postoperative complications provides relevant safety context.
What to keep in mind
The abstract reports one-month stone-free outcomes; longer-term outcomes are not provided.