Trial reportWorld journal of urology2026
Optimal duration of pre-stenting before RIRS: a prospective randomized study evaluating FANS-UAS placement success.
Trial report 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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Authors and funding
4 authors.
Funding
Abstract
purposeTo evaluate the impact of pre-stenting duration on flexible and navigable ureteral access sheaths (FANS-UAS) placement, as well as perioperative and postoperative outcomes, in patients undergoing retrograde intrarenal surgery (RIRS).
methodsA total of 221 patients were prospectively randomized into three groups: no pre-stenting (Group 1, n = 70), pre-stenting for 2-4 weeks (Group 2, n = 74), and pre-stenting for 4-6 weeks (Group 3, n = 77). Analyses were performed according to the intention-to-treat principle. The primary outcome was successful FANS-UAS placement. Secondary outcomes included successful RIRS, stone-free rate (SFR), stone-related secondary procedures, perioperative parameters, and postoperative complications. Post hoc pairwise comparisons and multivariable logistic regression analyses were performed to identify factors associated with FANS-UAS placement success.
resultsFANS-UAS placement success differed significantly among the groups, increasing from 80.0% in Group 1 to 93.2% and 94.8% in Groups 2 and 3, respectively (p = 0.006). Stone access time was markedly shorter in the pre-stented groups (p < 0.001). Successful RIRS (87.1%, 94.6%, and 94.8%; p = 0.146), SFR (84.3%, 87.8%, and 88.3%; p = 0.672), and secondary procedure rates (17.1%, 12.2%, and 7.8%; p = 0.224) were comparable among the groups. Post hoc analysis demonstrated meaningfully higher FANS-UAS placement success in pre-stented patients compared with non-stented patients, whereas no difference was observed between 2 and 4 and 4-6 weeks of pre-stenting. In multivariable logistic regression analysis, pre-stenting remained the only independent predictor of successful FANS-UAS placement (Group 2 vs. Group 1: adjusted OR 3.47, 95% CI 1.14-10.59, p = 0.029; Group 3 vs. Group 1: adjusted OR 5.31, 95% CI 1.60-17.68, p = 0.006). Clinically significant complications (≥ Grade III) were similar among the groups (12.9%, 12.2%, and 7.8%; p = 0.558).
conclusionsPre-stenting was independently associated with improved FANS-UAS placement success and facilitated ureteral access during RIRS. No statistically significant differences were detected between patients who underwent 2-4 weeks and those who underwent 4-6 weeks of pre-stenting.
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