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Does ureteral access sheath affect the outcomes of retrograde intrarenal surgery: a prospective study

Abstract Objectives To evaluate whether or not using a ureteral access sheath (UAS) affects the perioperative outcomes after retrograde intrarenal surgery (RIRS) performed in patients with renal stones. Material and methods An observational study was carried out using data of 60 patients who underwent RIRS with the diagnosis of renal stones <2 cm between February 2017 and November 2017 at our institution. The data of the 60 patients were registered prospectively during the study period. Patients were divided into two groups based on whether a UAS was used (Group 1–30 patients) or not (Group 2–30 patients) during RIRS. Perioperative outcomes and complications were collected and analyzed. Results The stone burdens of the patients in Group 1 and in Group 2 were 76.59 mm2 and 62.19 mm2, respectively (p = .160). There was no statistically significant difference in SFR (p = 1.000), complication rates (p = .418), and operation time (p = .411) between both groups, except for the fact that postoperative pain intensity levels using the VAS were slightly higher in Group 2 (4.13 ± 2.37 vs. 5.33 ± 1.89, p = .064). Conclusions In the present study, we showed that similar success and acceptable complication rates can be achieved without using UAS compared to using UAS during RIRS. However, using UAS may provide an advantage in reducing postoperative pain after RIRS.