http://orcid.org/0000-0001-7962-1640
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Abstract
Objective: The aim of this study was to evaluate the incidence of ureteral lesions in retrograde intrarenal surgery (RIRS) with and without the use of a 10/12 Fr ureteral access sheath (UAS). A further objective was to search for preoperative factors that could influence the risk of ureteral damage.
Materials and methods: Data were collected from a clinical database on 180 consecutive adult patients undergoing RIRS for kidney stones with or without a 10/12 Fr UAS. The primary outcome measure was ureteral lesions endoscopically identified at the end of surgery using the Post-Ureteroscopic Lesion Scale (PULS) classification system.
Results: The use of 10/12 Fr UASs resulted in less severe lesions than reported previously with larger diameter UASs. There was a higher risk of superficial lesions in the UAS group, with a calculated crude odds ratio (OR) of 1.84 [95% confidence interval (CI) 1.00–3.37]. When adjusting for age and gender, the OR was 1.68 (95% CI 0.90–3.13; p = 0.10) and thus was not significant. The only factor that remained significant was age (OR =1.02/year, 95% CI 1.00–1.04).
Conclusion: There was a trend towards a higher risk of ureteral lesions in RIRS with a 10/12 Fr UAS compared with an endoscope alone, but when adjusting for age and gender the incidence of ureteral lesions was comparable between RIRS with and without the use of a 10/12 Fr UAS.
Disclosure statement
K. H. Andreassen has received speaker honoraria from Boston Scientific. P. J. S. Osther is a member of the advisory boards of Olympus, Boston Scientific, Bonvisi AB and Coloplast, and has received speaker honoraria from Olympus, Cook Medical, Boston Scientific, Karl Storz Endoskope and Coloplast. The rest of the authors have no conflicts of interest.