The use of a ureteral access sheath does not improve stone-free rate after ureteroscopy for upper urinary tract stones

摘要

Purpose: To evaluate the impact of a ureteral access sheath (UAS) on stone-free (SF) rate after flexible ureteroscopy for upper urinary tract stones. Materials and methods: We retrospectively reviewed 280 patients who underwent flexible ureteroscopy (URS) for upper urinary tract stone between 2009 and 2012. Patients were divided into two groups based on whether a UAS was used (n = 157) or not (n = 123). SF rate was evaluated at one and three months after surgery by abdominal imaging. Quantitative and qualitative variables were compared with Student's t test and χ2 test, respectively. A logistic regression model was used to determine the predictive factors of SF status. Results: Stone size was similar in both groups (15.1 vs. 13.7 mm, p = 0.21). SF rates at one and 3 months were comparable in UAS and non-UAS groups (76 vs. 78 % and 86 vs. 87 %, p = 0.88 and 0.89, respectively). Complication rates were similar in both groups (12.7 vs. 12.1 %, p = 0.78). In multivariable analysis, stone size was the only predictive factor of SF rate (p = 0.016). Conclusion: The routine use of a UAS did not improve SF rate in patients undergoing flexible URS for upper urinary tract calculi.