Does ureteral access sheath have an impact on ureteral injury?

Abstract

Objective: To present a well-organized review about ureteral access sheath impact on ureteral injury. Materials and Methods: Systemic search on literature was done. Total of 3766 studies observed by two urologists and results were unified. A Prisma diagram was used for eliminating irrelevant studies and at the end of elimination process 28 studies were found eligible for this review. Results: Not only clinical studies but also comparative experimental animal studies show that there is no significant data to claim that ureteral access sheath insertion causes more ureteral injury. Pre-stented patients were found to be at lower risk for ureteral injury. Risk of progression to ureteral injury seems to be low even if ureteral injury occurs with insertion of ureteral access sheath. Conclusion: Summary of studies’ results indicate that use of ureteral access sheath doesn’t increase ureteral injury. This review may help understanding safety profile of ureteral access sheath on evidence-based level. There is not enough data to make a statement that ureteral access sheath prevents ureteral injury.

Does preoperative silodosin administration facilitate ureteral dilatation during flexible ureterorenoscopy? A randomized clinical trial

“…We propose that by blocking α-adrenergic receptors, silodosin diminishes the strength of ureteral contractions and the frequency of ureteral peristalsis, resulting in a more relaxed and less active ureter. This relaxation allows for the utilization of a reinforced UAS, which, in turn, can generate significant shear stress, potentially leading to various levels of damage to the ureteral wall, ranging from mucosal erosion to ureteral avulsion [18].…”

Ureteral access sheath. Does it improve the results of flexible ureteroscopy? A narrative review

“…Additionally, no association was found between ureteral stricture and the use of the UAS. However, few studies are providing long-term follow-up to assess such late complications ( 44 ).…”