Flexible and navigable suction ureteral access sheath combined with flexible ureteroscopy for proximal impacted ureter stones: a retrospective case series.

Yan Wang, Dongdong Guo, Tao Wang, Xinyu Zhai, Cheng Ma, Dongliang Xu, Chuanmin Chu

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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. Not yet cited in PubMed.

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5 · Who and what money

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7 authors.

Yan Wang *Urology Centre, Shuguang Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.

Dongdong Guo *Urology Centre, Shuguang Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.

Tao Wang *Urology Centre, Shuguang Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.

Xinyu ZhaiUrology Centre, Shuguang Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.

Cheng MaUrology Centre, Shuguang Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.

Dongliang XuUrology Centre, Shuguang Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.

Chuanmin ChuUrology Centre, Shuguang Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China. sgyyccm@yeah.net.

Funding

he Promotion and Optimization Management of Diagnosis and treatment technology in Municipal Hospitals of Shanghai Shenkang Hospital Development Center SHDC12023113the Health Discipline Leader Program of Shanghai Health Commission 2022XD011

6 · The paper itself

Abstract

objectiveTo evaluate the technical feasibility and clinical outcomes of flexible and navigable suction ureteral access sheath (FANS) combined with flexible ureteroscopy (fURS) for proximal impacted ureter stones (PIUS) and identify predictors of residual fragments (RF).

methodsThis single-center retrospective study included 45 patients with PIUS who underwent FANS-fURS (August 2023-February 2025). The surgical procedure involved FANS deployment, laser lithotripsy, and real-time suction-assisted fragment clearance. Stone-free status (SFS) was assessed at 30 days postoperatively, with Grades B-D defined as RF. Multivariate logistic regression analyzed predictors of RF.

resultsThe median age was 55 years (IQR: 41.5-61.5), with 71.1% male. Postoperative SFS were Grade A (40.00%), B (51.11%), C (6.67%), and D (2.22%). Multivariate analysis identified larger sheath size as protective against RF (OR: 0.061, P = 0.025), while larger stone diameter (OR: 1.593, P = 0.031) and higher polyp occupancy within the lumen (OR: 1.919, P = 0.040) increased RF risk. Median operative time was 42 min (IQR: 33.5-65.0).

conclusionThe combination of FANS and fURS demonstrated high efficacy in managing PIUS, achieving favorable stone clearance rates. Sheath size, stone diameter, and polyp occupancy within the lumen are significant predictors of RF, which can help optimize surgical strategy.

Indexed as

Ureteral CalculiUreteroscopesUreteroscopyAdultEquipment DesignFeasibility StudiesFemaleHumansLithotripsy, LaserMaleMiddle AgedRetrospective StudiesSuctionTreatment OutcomeFlexible and navigable suction ureteral access sheathFlexible ureteroscopyProximal impacted ureter stones

Identifiers

PMID42068334

DOI10.1007/s00345-026-06447-5

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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.