Contribution of Ureteral Access Sheath Use to The Efficacy of Semirigid Ureterorenoscopy in Upper Ureteral Stones Smaller Than 2 Cm: Experiences of A Single Center

Objective: The aim of our paper is to answer the question that during the ureteroscopy procedure if ureteral access sheath could facilitate operation, could decrease complication rates,operation time,requirement of additional surgery.
Method: The patients were randomly divided into two groups. Group 1 contained 44 patients for whom a UAS was not used and Group 2 consisted of 70 patients for whom a UAS was used during the URS procedure. The operation was continued using the semirigid ureteroscope within the UAS.
Results: There were no statistically significant differences between the two groups in terms of the mean age, BMI, ASA score, mean stone density, previous unsuccessful interventions, history of stone disease, mean grade of hydronephrosis in renal pelvis and mean stone size. the mean operation time was 41 minutes for Group 1 and 30 minutes for Group 2, with a statistically significant difference (p < 0.001), consistent with the literature. Similarly, the difference in the mean fluoroscopy time was statistically significant, being determined as six minutes for Group 1 and three minutes for Group 2 (p < 0.001).
Conclusions: Use of UAS was statistically significantly superior in terms of many parameters, such as increased stone-free rate, shorter operation time, and reduced requirement of additional surgery. Furthermore, the complication rates did not significantly differ between the UAS and non-UAS groups. We also consider that the advantages of a higher stone-free rate and reduced requirement of secondary interventions make the cost of UAS acceptable.