Ureteroscopic lithotripsy with pressure-measuring ureteral access sheath for large ureteral stones

Abstract

Introduction

To evaluate the safety and efficacy of ureteroscopic lithotripsy with pressure-measuring ureteral access sheath (PM-UAS) for large ureteral stones.

Material and methods

A total of 258 consecutive patients with large ureteral stones ≥15 mm was enrolled. They were treated by ureteroscopic lithotripsy with PM-UAS in the oblique supine lithotomy position. The technology can precisely monitor and automatically control cavity pressure. The cavity pressure control value was set at –15 mmHg∼–5 mmHg. The cavity pressure limit value was set at 30 mmHg. Infusion flow rate was set at 100–200 ml/min. Postoperative data such as stone-free rate and complications were analyzed.

Results

PM-UAS was successfully implanted in 225 patients at one stage. Eighteen cases of patients who had failed the first surgery were successfully treated with a second operation. Fifty-one cases with stones migrating up to the kidney were converted to flexible lithotripsy. The other 15 cases were converted to percutaneous nephrolithotomy due to significant ureteral stenosis. The operative time was 49.5 ± 11.2 min. The stone-free rates after one month and three months were 87.2% (212/243) and 94.2% (229/243), respectively. Complications from grade I to II were observed in 25(10.3%) patients. No other complications from grade III to V were noted

Conclusion

The ureteroscopic lithotripsy with PM-UAS is safe and efficacious for large ureteral stones.

Keywords:

• Ureteroscopic lithotripsy
• pressure-measuring
• ureteral access sheath
• large ureteral stones

Declaration of interest

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by the following funds: Jiangxi Provincial Science and Technology Agency projects (20181BAB215011), Ganzhou Science and Technology Innovation Talent Plan of 2019, Ganzhou Science and Technology Bureau Science and technology plan project of 2022.