The Effect of Extralumenal Safety Wires on Ureteral Injury and Insertion Force of Ureteral Access Sheaths: Evaluation Using an Ex Vivo Porcine Model

Graversen, Joseph A.; Valderrama, O; Korets, Ruslan; Mues, Adam C.; Landman, Jaime; Badani, Ketan K.; Gupta, Mantu

doi:10.1016/j.urology.2011.11.002

Cited by 10 publications

(5 citation statements)

References 12 publications

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“…In another study, the insertion forces of a UAS on ex vivo porcine ureter were measured with and without safety guidewire. [ 8 ] The results showed that the use of a safety guidewire increased the insertion forces but there was no significant difference in rates of ureteral injury.…”

Section: Resultsmentioning

confidence: 99%

Does ureteral access sheath have an impact on ureteral injury?

et al. 2022

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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.

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Section: Resultsmentioning

confidence: 99%

Does ureteral access sheath have an impact on ureteral injury?

et al. 2022

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“…Currently, this device is not commercially available. Graversen et al assessed the impact of safety guidewires on 12/14 F UAS insertion and revealed a twofold increase in the mean and maximum insertion force when a safety guidewire was placed outside of the UAS. In that study, the increased insertion force did not translate into an increase in ureteral wall injuries.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of ureteral access sheaths: facts and myths

et al. 2018

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The aim of the present paper was to review the literature on all available ureteral access sheaths (UASs) with their indications, limitations, risks, advantages and disadvantages in current modern endourological practice. Two authors searched Medline, Scopus, Embase and Web of Science databases to identify studies on UASs published in English. No time period restriction was applied. All original articles reporting outcomes or innovations were included. Additional articles identified through references lists were also included. Case reports, editorials, letters, review articles and meeting abstracts were excluded. A total of 754 abstracts were screened, 176 original articles were assessed for eligibility and 83 articles were included in the review. Based on a low level of evidence, UASs increase irrigation flow during flexible ureteroscopy and decrease intrapelvic pressure and probably infectious complications. Data were controversial and sparse on the impact of UASs on multiple reinsertions and withdrawals of a ureteroscope, stone-free rates, ureteroscope protection or damage, postoperative pain, risk of ureteral strictures, and also on its cost-effectiveness. Studies on the benefit of UASs in paediatrics and in patients with a coagulopathy were inconclusive. In the absence of good randomized data, the true impact of UASs on surgery outcome remains unclear. The present review may contribute to the evidence-based decision-making process at the individual patient level regarding whether or not a UAS should be used.

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“…[8][9][10] The use of a safety wire increases the force required to advance a semi-rigid ureteroscope, 11 and in porcine models, affects the force required to advance a ureteral access sheath. 12 However, in our opinion, should an injury occur, not being able to then place a wire is a risk not taken lightly. Flexible wires composed of nitinol or superelastic alloy cores are used as safety wires so that they do not become obstacles during scope manipulation.…”

Section: Commentsmentioning

confidence: 91%