Efficacy of Percutaneous Antegrade Flexible Ureteroscopic Lithotripsy with Tip-Bendable Suction Ureteral Access Sheath for Middle and Lower Ureteral Stones.

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2025-10-04 DOI:10.1159/000548754

Zhongping Liu, Huifang Lei, Zhiwen Wang, Qiliang Zhai, Xin Huang

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Abstract

Introduction: To evaluate the efficacy and safety of percutaneous antegrade flexible ureteroscopic lithotripsy (PAFUL) using a tip-bendable suction ureteral access sheath (UAS) for managing middle and lower ureteral stones after failed retrograde ureteroscopy.

Methods: This retrospective study analyzed 75 patients (43 males, 32 females; mean age 51.7±13.1 years) with middle (n=54) and lower (n=21) ureteral stones treated between June 2023 and May 2025. All patients underwent PAFUL with 12/14 Fr tip-bendable suction UAS after failed ureteroscopy. Outcomes included stone-free rate (SFR), operative time, complications, and hydronephrosis improvement.

Results: The immediate and one-month SFR was 100% (75/75). The mean operative time was 168.2±35.9 minutes, with a median postoperative hospital stay of 3 days. Four patients (5.3%) required nephrostomy tube placement. Complications (Clavien-Dindo grade I) included fever (n=2), nausea/vomiting (n=8), and pain (n=18). No grade II-V complications occurred. Postoperative hydronephrosis significantly improved (P < 0.001), with complete resolution in 68 patients (90.7%).

Conclusion: PAFUL with tip-bendable suction UAS is a safe and immediately effective alternative for mid-distal ureteral stones after failed retrograde treatment, achieving single-session clearance with minimal morbidity. Future studies should validate cost-effectiveness through reduced re-interventions and resource utilization.

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经皮顺行柔性输尿管镜下取石术治疗输尿管中下段结石的疗效观察。

前言：评价经皮顺行柔性输尿管镜碎石术（PAFUL）治疗逆行输尿管镜检查失败后输尿管中下段结石的疗效和安全性。方法：回顾性分析2023年6月至2025年5月期间治疗的输尿管中段（n=54）和下段（n=21）结石患者75例（男性43例，女性32例，平均年龄51.7±13.1岁）。所有患者输尿管镜检查失败后均行12/14 Fr可弯曲吸力UAS的pafl。结果包括无结石率（SFR）、手术时间、并发症和肾积水改善。结果：即刻和1个月SFR为100%（75/75）。平均手术时间168.2±35.9分钟，术后中位住院时间3天。4例（5.3%）患者需要置肾造口管。并发症（Clavien-Dindo I级）包括发热（n=2）、恶心/呕吐（n=8）和疼痛（n=18）。无II-V级并发症发生。术后肾积水明显改善（P < 0.001）， 68例（90.7%）患者完全痊愈。结论：对于逆行治疗失败的输尿管中远端结石，PAFUL与尖端可弯曲吸力UAS是一种安全且立即有效的替代方案，可实现单次清除，发病率最低。未来的研究应通过减少再干预和资源利用来验证成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.