Evidence map›Paper›PMID 41689658›Full record

ArticleWorld journal of urology2026

Efficacy and safety of flexible and navigable suction ureteral access sheath combined with flexible ureteroscopic lithotripsy versus flexible ureteroscopic lithotripsy alone for infected upper urinary tract stones: a retrospective cohort study.

Qianhao Huang, Meixuan Ding, Xin Lian, Yifan Huang, Tao Wang, Bin Chen, Yuedong Chen

Abstract readComparative Study
In one paragraph

Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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

7 authors.

Qianhao Huang *The Key Laboratory of Urinary Tract Tumours and Calculi, Department of Urology, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen, 361003, Fujian, China.
Meixuan Ding *The Graduate School, Fujian Medical University, Fuzhou, 350122, China.
Xin Lian *The Graduate School, Fujian Medical University, Fuzhou, 350122, China.
Yifan HuangThe Graduate School, Fujian Medical University, Fuzhou, 350122, China.
Tao WangThe Key Laboratory of Urinary Tract Tumours and Calculi, Department of Urology, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen, 361003, Fujian, China.
Bin ChenThe Graduate School, Fujian Medical University, Fuzhou, 350122, China. chenbin5557@163.com.
Yuedong ChenThe Graduate School, Fujian Medical University, Fuzhou, 350122, China. chenyuedong8@126.com.

Funding

Department of Science and Technology of Fujian Province (#2022J011353 and 2020CXB046).
6 · The paper itself

Abstract

objectiveTo compare the efficacy and safety of flexible negative-pressure ureteral access sheath combined with flexible ureteroscopic lithotripsy (FURL) versus FURL alone in the treatment of upper urinary tract infectious stones.

methodsThis retrospective cohort study included 91 patients with upper urinary tract infectious stones (confirmed as struvite or carbonate apatite by postoperative stone composition analysis) who underwent surgery at the First Affiliated Hospital of Xiamen University between January 2023 and January 2025. Based on the surgical approach, patients were divided into two groups: the FANS-UAS combined with FURL group (n = 60) and the FURL alone group (n = 31). Baseline characteristics, stone-free rates (immediate and long-term), and complications were collected and compared between the groups.

resultsCompared to the FURL alone group, the FANS-UAS group had a lower proportion of struvite stones (73.33% vs. 93.55%, P < 0.05) and a lower rate of intraoperative stone basket usage (66.67% vs. 100%, P < 0.05). However, patients in the FANS-UAS group were older, had a larger maximum stone diameter, and higher stone CT values (all P < 0.05). Regarding efficacy and safety: The FANS-UAS group demonstrated a significantly higher immediate stone-free rate (53.34% vs. 12.91%, P < 0.05), but also had a longer operative time, greater estimated intraoperative blood loss, and higher postoperative levels of serum creatinine and cystatin C (all P < 0.05). Concurrently, the FANS-UAS group showed significantly lower rates of systemic inflammatory response syndrome (1.67% vs. 6.45%, P < 0.05), lower hospitalization costs, and a lower rate of postoperative adjuvant therapy (3.33% vs. 45.17%, P < 0.05). However, no statistically significant differences were observed between the two groups in terms of long-term stone-free rate, postoperative pain scores, length of hospital stay, transfusion rate, fever rate, renal pelvis/ureteral injury rate, or reoperation rate (all P > 0.05). Although these differences did not reach statistical significance, the observed numerical trends in some outcomes may hold clinical relevance and warrant further validation through larger-scale studies.

conclusionThe combination of FANS-UAS and FURL is a safe and effective method for treating upper urinary tract infectious stones. Its advantages include a higher immediate stone-free rate, lower hospitalization costs, reduced need for postoperative adjuvant therapy, a lower incidence of sepsis, and faster postoperative recovery, while achieving a long-term stone-free rate comparable to FURL alone. This approach represents a viable new treatment option.

Indexed as

Kidney CalculiLithotripsyUreteral CalculiUreteroscopyUrinary Tract InfectionsAdultCohort StudiesCombined Modality TherapyFemaleHumansMaleMiddle AgedRetrospective StudiesSuctionTreatment OutcomeUreteroscopesFlexible and navigable suction ureteral access sheathsFlexible ureteroscopic lithotripsyInfected stonesStruvite stonesUpper urinary tract stones

Identifiers

PMID41689658
PMCPMC12906553

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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.