Ureteral Access Sheaths and Its Use in the Future : A Comprehensive Update Based on a Literature Review
De Coninck, Vincent (Progressive Endourological Association for Research and Leading Solutions (PEARLS))
Somani, Bhaskar K (University Hospital Southampton)
Sener, Emre Tarik (Department of Urology. Marmara University School of Medicine)
Emiliani, Esteban (Institut d'Investigació Biomèdica Sant Pau)
Corrales, Mariela (Groupe de Recherche Clinique sur la Lithiase Urinaire. Hô Tenon)
Juliebø-Jones, Patrick (Department of Clinical Medicine. University of Bergen)
Pietropaolo, Amelia (University Hospital Southampton)
Mykoniatis, Ioannis (Department of Urology. Faculty of Health Sciences. School of Medicine. Aristotle University of Thessaloniki)
Zeeshan Hameed, Belthangady M. (Kasturba Medical College Manipal)
Esperto, Francesco (Unit of Urology. Magna Graecia University of Catanzaro)
Proietti, Silvia (Department of Urology. IRCCS San Raffaele Hospital)
Traxer, Olivier (Groupe de Recherche Clinique sur la Lithiase Urinaire. Hô Tenon)
Keller, Etienne Xavier (University Hospital Zurich (Suïssa))
Universitat Autònoma de Barcelona

Data:	2022
Resum:	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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Matèria:	Urolithiasis ; Nephrolithiasis ; Ureteroscopy ; Retrograde intrarenal surgery ; Ureteral access sheath ; Systematic review
Publicat a:	Journal of clinical medicine, Vol. 11 Núm. 17 (september 2022) , p. 5128, ISSN 2077-0383

DOI: 10.3390/jcm11175128
PMID: 36079058

11 p, 761.1 KB

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