ArticleBMC urology2025
In-depth exploration and initial clinical practice of the ratio of endoscope-sheath diameter theory: smaller flexible ureteroscope with smaller ureteral access sheath.
Article in BMC urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo assess the outcomes of combining a 7.5Fr flexible ureteroscope (fURS) with a 10/12F ureteral access sheath (UAS) through a comprehensive in vitro and in vivo evalu-ation.
methodsWe conducted a comparative analysis, evaluating the impact of a 7.5Fr fURS in contrast to others on in trapelvic pressure (IPP) and perfusion fluid flow rate (PFFR) in vitro. This assessµent involved varying ratios of endoscope-sheath diaµeter (RESDs). Subsequently, we prospectively enrolled 23 patients with renal calculi <2 cm who underwent laser lithotripsy using the coµbination of a 7.5Fr fURS and a 10/12F UAS. The patients' profiles, including preoperative, operative inforµation and postoperative coµplications, were recorded.
resultsIn vitro experi-ments revealed that IPP and PFFR remained optimal when the RESDs were ≤ 0.75. Notably, only the 7.5Fr fURS ensured a safe IPP when combined with a 10/12F UAS. In clinical research, the sheath placement success rate was 100%, with an average operation time of 55.0 ± 20.0 min and a lithotripsy time of 150.4 ± 199.0 s. Mild ureteral injury necessitated the retention of a double-J stent in five cases for a month. The hospitalization duration and 24-h pain score averaged 45.6 ± 15.5 h and 4.3 ± 3.5, respectively. The one-month stone-free rate was 91.3%. Regarding stent-related symptoms, the overactive bladder symptom score averaged 1.7 ± 1.5, the international prostate symptom score was 3.3 ± 2.8, and the quality of life was 1.3 ± 1.7.
conclusionsCombining a 7.5Fr fURS with a 10/12Fr UAS is recommended as a secure option for treating renal calculi < 2 cm. Postoperative pain management is a future concern.
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