Predicting an Effective Ureteral Access Sheath Insertion: A Bicenter Prospective Study

• DOI: 10.1089/end.2014.0215
• Publication Date: 2014-09-22T16:13:26Z
• Authors: Yakov Mogilevkin; Mario Sofer; David Margel; Alexander Greenstein; David Lifshitz
• Keywords: Ureteroscopy

Introduction: The use of a ureteral access sheath (UAS) may provide significant advantages, particularly, in the treatment large renal stone burden. However, some patients, passage UAS up ureter is impossible. We prospectively evaluated ability to insert 14F and analyzed possible predictors for an effective insertion. Patients Methods: In bicenter prospective study, 248 consecutive patients undergoing ureteroscopy retrograde intrarenal surgery (RIRS) were recruited. each case, we attempted initially pass Flexor-Cook UAS. If was difficult, gradual dilation using semirigid dilators (Cook Medical) performed. categorized into three groups: passage, with without dilation, failure Age, gender, body–mass index (BMI), indwelling Double-J stent, history previous or stent all analyzed, as Results: 22% could not Of preoperative parameters that examined, found independent insertion: age (odds ratio: 1.5 95% CI [1.3, 1.9]), same-side procedures 9.7 [8.3, 14.5]), 21.73 [20, 30]). BMI, side did predict success rate. Conclusions: Insertion before RIRS fail approximately one-fifth patients. An older are