A novel bendable suction sheath in flexible ureteroscopy for renal calculi.

Abstract

ObjectivesThis study aimed to evaluate the clinical efficacy and cost-effectiveness of using a disposable bendable negative pressure suction sheath in combination with a disposable ureteroscope for treating upper urinary tract calculi and to compare it with the conventional ureteral access sheath with a lassoed mesh basket.MethodsA retrospective analysis was conducted on clinical data from patients with upper urinary tract calculi who underwent flexible ureteroscopy at a tertiary hospital in Beijing between March 2023 and March 2024. The study included two groups: 69 patients were treated with disposable bendable negative pressure suction sheaths (negative pressure group) and 83 with conventional ureteral access sheath combined with lassoed mesh baskets (conventional group). Variables analyzed included operative time, stone-free rate, length of postoperative hospital stay, postoperative complication rate, and hospitalization cost.ResultThe operative time for the negative pressure group was 119.8 ± 10.4 min, which was longer than that in the conventional group (93.2 ± 9.8 min). The postoperative hemoglobin drop was 5.3 ± 2.2 g/L in the negative pressure group and 4.7 ± 1.2 g/L in the conventional group. The hospitalization cost for the negative pressure group was ¥28,273 ± 5389, which was significantly lower than that for the conventional group (¥30,786.1 ± 4055). The stone-free rate at 1 week postoperatively was 84.1% (58/69) in the negative pressure group, which was significantly higher than that in the conventional group (68.7%). However, there was no statistically significant difference in stone-free rate at 1 month postoperatively between the two groups.ConclusionsThe use of a disposable ureteroscope with a bendable negative pressure suction sheath can improve short-term postoperative stone-free rate. However, this approach may increase surgical complexity, extend operative time, and heighten the risk of intraoperative bleeding. This procedure is recommended to be performed by physicians with extensive experience in flexible ureteroscopy to ensure safety and efficacy.