90d696191eae75c68311005acab6f45f 277711.pdf 808b3e02910858e6cd210b07892b7812a739f58d 277711.pdf 389ef736605046f72f3c1d75077d16e4ed85b35676d8be361b0792757edb47e4 277711.pdf Title: Ureteral Access Sheaths and Its Use in the Future: A Comprehensive Update Based on a Literature Review Subject: Ureteral access sheaths (UASs) are part of urologist’s armamentarium when performing retrograde intrarenal surgery (RIRS). Recently, the world of RIRS has changed dramatically with the development of three game-changers: thulium fiber laser (TFL), smaller size single use digital flexible ureterosopes and intraoperative intrarenal pressure (IRP) measurement devices. We aimed to clarify the impact of UASs on IRP, complications and SFRs and put its indications in perspective of these three major technological improvements. A systematic review of the literature using the Medline, Scopus and Web of Science databases was performed by two authors and relevant studies were selected according to PRISMA guidelines. Recent studies showed that using a UAS lowers IRP and intrarenal temperature by increasing irrigation outflow during RIRS. Data on the impact of a UAS on SFRs, postoperative pain, risk of infectious complications, risk of ureteral strictures and risk of bladder recurrence of urothelial carcinoma after diagnostic RIRS were inconclusive. Prestenting for at least one week resulted in ureteral enlargement, while the influence of pre-operative administration of alpha-blockers was unclear. Since TFL, smaller single use digital ureteroscopes and devices with integrated pressure-measuring and aspiration technology seemed to increase SFRs and decrease pressure and temperature related complications, indications on the use of a UAS may decrease in the near future. Keywords: urolithiasis; nephrolithiasis; ureteroscopy; retrograde intrarenal surgery; ureteral access sheath; systematic review Author: Vincent De Coninck, Bhaskar Somani, Emre Tarik Sener, Esteban Emiliani, Mariela Corrales, Patrick Juliebø-Jones, Amelia Pietropaolo, Ioannis Mykoniatis, Belthangady M. Zeeshan Hameed, Francesco Esperto, Silvia Proietti, Olivier Traxer and Etienne Xavier Keller Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Aug 31 09:47:54 2022 CEST ModDate: Wed Aug 31 10:07:00 2022 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 779339 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MPQMMF+VnURWPalladioL Type 1 Custom yes yes no 10 0 VLQFKZ+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 WAQEZG+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 KMOGIH+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 QGUKZH+CMSY10 Type 1 Builtin yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 49 0 MJNBMA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 79 0 MJNBNC+PalatinoLinotype TrueType WinAnsi yes yes no 82 0 MJNBNE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 85 0 MJNDGL+SimSun CID TrueType Identity-H yes yes yes 88 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-07-21 02:36:47 CEST RepresentationInformation: 277711.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-07-20 14:53:07 CEST Size: 779339 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 344 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Children: Item: Title: Intrarenal Pressure (IRP) Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Temperature Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Stone Free Rates Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Complications Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Pain Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Infections Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Lesions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Strictures Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: UAS and the Three Game Changers Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Children: Item: Title: TFL Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Small Digital Flexible Ureteroscope Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Modified UAS with Pressure Control Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Item: Title: Influence of Prestenting and Alpha Blockers Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: UAS and UTUC Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@76a3e297 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4d3167f4 Info: Title: Ureteral Access Sheaths and Its Use in the Future: A Comprehensive Update Based on a Literature Review Author: Vincent De Coninck, Bhaskar Somani, Emre Tarik Sener, Esteban Emiliani, Mariela Corrales, Patrick Juliebø-Jones, Amelia Pietropaolo, Ioannis Mykoniatis, Belthangady M. Zeeshan Hameed, Francesco Esperto, Silvia Proietti, Olivier Traxer and Etienne Xavier Keller Subject: Ureteral access sheaths (UASs) are part of urologist’s armamentarium when performing retrograde intrarenal surgery (RIRS). Recently, the world of RIRS has changed dramatically with the development of three game-changers: thulium fiber laser (TFL), smaller size single use digital flexible ureterosopes and intraoperative intrarenal pressure (IRP) measurement devices. We aimed to clarify the impact of UASs on IRP, complications and SFRs and put its indications in perspective of these three major technological improvements. A systematic review of the literature using the Medline, Scopus and Web of Science databases was performed by two authors and relevant studies were selected according to PRISMA guidelines. Recent studies showed that using a UAS lowers IRP and intrarenal temperature by increasing irrigation outflow during RIRS. Data on the impact of a UAS on SFRs, postoperative pain, risk of infectious complications, risk of ureteral strictures and risk of bladder recurrence of urothelial carcinoma after diagnostic RIRS were inconclusive. Prestenting for at least one week resulted in ureteral enlargement, while the influence of pre-operative administration of alpha-blockers was unclear. Since TFL, smaller single use digital ureteroscopes and devices with integrated pressure-measuring and aspiration technology seemed to increase SFRs and decrease pressure and temperature related complications, indications on the use of a UAS may decrease in the near future. 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