Trial reportWorld journal of urology2023
Effect of bladder emptying status on the ureteral access sheath insertion resistance and following ureteral injury in RIRS: a prospective randomized controlled trial in academic hospital.
Trial report in World journal of urology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.
- Comparison of regional and general anesthesia for retrograde intrarenal surgery: a systematic review and meta-analysis.Frontiers in surgery · 2025Pooled it
- Prostatic morphometric parameters and ureteral access sheath placement failure during retrograde intrarenal surgery: a retrospective cohort study.BMC urology · 2026Article
- Article
- Iatrogenic upper urinary tract injuries during ureteroscopy for urolithiasis: a comprehensive review on incidence, mechanisms and preventative strategies.Nature reviews. Urology · 2025Review
- The role of preoperative ureteral diameter measurements in predicting difficult access during retrograde ıntrarenal surgery: a retrospective analysis of 234 patients.Urolithiasis · 2025Article
- The role of preoperative ureteral stenting in retrograde intrarenal surgery outcomes for renal stones: a matched-pair analysis.Central European journal of urology · 2024Article
- Predictive factors for difficult ureter in primary kidney stone patients before retrograde intrarenal surgery.Central European journal of urology · 2024Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
purposeTo evaluate the effect of bladder emptying status on the ureteral access sheath (UAS) insertion resistance and following ureteral injury.
methodsEighty patients were enrolled and randomly divided into bladder emptying group and control group before UAS placement. A digital force gauge (Imada Z2-50N) was used to measure the resistance during the UAS insertion. The ureteral injury was evaluated and graded with Post-Ureteroscopic Lesion Scale (PULS) system at the end of procedure. The mean resistance, maximum resistance in different ureteral segments, and ureteral injury were compared between the two groups.
resultsThe mean resistance (3.12 ± 0.49 vs. 4.28 ± 0.52 N, P < 0.001), maximum resistance in the whole procedure (5.17 ± 0.72 vs. 6.39 ± 0.96 N, P < 0.001) and distal ureter (3.07 ± 0.75 vs. 6.18 ± 1.17 N, P < 0.001) in the bladder emptying group were significantly lower when compared to the control group. In subgroup analysis, the similar result was also noted in patients with BMI ≥ 25 when compared to patients with BMI < 25, while there was no significant difference between men and women, age ≥ 50 years versus age < 50 years. The incidence of PULS 1-2 ureteral injury in the bladder emptying group was lower than the control group (35% vs. 55%, P = 0.045). The ureteral injury in distal ureteral was less frequently noted in bladder emptying group than the control group (22.5% vs. 55%, P = 0.006); however, there was no significant difference in middle and upper ureter (P > 0.05).
conclusionEmptying the bladder before UAS insertion can effectively reduce the UAS insertion resistance and the risk of distal ureteral injury in RIRS.
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