Evidence map›Paper›PMID 39776554›Full record

ArticleArab journal of urology2025

The efficacy of flexible ureteroscopy for large volume stones and hazards of ureteral access sheath usage: A prospective randomized study.

Ahmed M Rammah, Farouk Khaled, Samih Zamel, Amr Elkady, Samer Morsy, Mohamed Abdelwahab

Abstract read
In one paragraph

Article in Arab journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ahmed M RammahDepartment of Urology, Kasr Alainy Hospitals, Faculty of Medicine, Cairo University, Cairo, Egypt.ORCID https://orcid.org/0000-0002-4762-0210
Farouk KhaledDepartment of Urology, Kasr Alainy Hospitals, Faculty of Medicine, Cairo University, Cairo, Egypt.
Samih ZamelDepartment of Urology, Kasr Alainy Hospitals, Faculty of Medicine, Cairo University, Cairo, Egypt.
Amr ElkadyDepartment of Urology, Kasr Alainy Hospitals, Faculty of Medicine, Cairo University, Cairo, Egypt.
Samer MorsyDepartment of Urology, Kasr Alainy Hospitals, Faculty of Medicine, Cairo University, Cairo, Egypt.
Mohamed AbdelwahabDepartment of Urology, Kasr Alainy Hospitals, Faculty of Medicine, Cairo University, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: We aimed to assess the stone free rate of flexible ureteroscopy and laser lithotripsy (FURL) in upper urinary tract stones (UUTS) >20 mm and the risk of complications from ureteral access sheath (UAS) usage. Methods: This is a prospective randomized clinical trial that included patients with UUTS larger than 20 mm who underwent FURL after randomization into two groups: group A (UAS) and group B (non-UAS). Data were collected for patients' demographics, stone parameters, operative and postoperative complications, and the outcome of FURL regarding stone-free rate (SFR) and perioperative complications, with a 6-month follow-up. Stone clearance was defined as the absence of fragments or the presence of fragments smaller than 2 mm on follow-up CT scans of the urinary tract (CTUT). Results: One hundred and fifty-nine patients were evaluated. The mean stone size was 27.08 ± 6.185 mm. Complete stone-free status was achieved in 84.9% of the patients. No significant difference was detected between both groups regarding operative time or SFR. The ureteric injury was identified in 13 (8.1%) patients (10 in group A and 3 in group B, p: 0.0481). Five of them, from group A, revealed hydronephrosis after stent removal. Postoperative pain and fever were documented in 50 and 22 patients, respectively, without significant differences between both groups. Postoperative sepsis occurred in 7 patients (2 in group A, 5 in group B, p: 0.380) who required supportive care. Conclusion: FURL without UAS is a safe and efficient treatment for upper urinary tract stones larger than 20 mm in the form of lower risk of ureteric injury.

Indexed as

Flexible ureteroscopylaser lithotripsyureteral access sheathureteric injury

Identifiers

PMID39776554
PMCPMC11703511

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.