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Objectives <p>To assess the outcomes of combining a 7.5Fr flexible ureteroscope (fURS) with a 10/12F ureteral access sheath (UAS) through a comprehensive in vitro and in vivo evalu-ation.</p> Methods <p>We conducted a comparative analysis, evaluating the impact of a 7.5Fr fURS in contrast to others on in trapelvic pressure (IPP) and perfusion fluid flow rate (PFFR) in vitro. This assessµent involved varying ratios of endoscope−sheath diaµeter (RESDs). Subsequently, we prospectively enrolled 23 patients with renal calculi &lt;2&#xa0;cm who underwent laser lithotripsy using the coµbination of a 7.5Fr fURS and a 10/12F UAS. The patients’ profiles, including preoperative, operative inforµation and postoperative coµplications, were recorded.</p> Results <p>In vitro experi-ments revealed that IPP and PFFR remained optimal when the RESDs were ≤ 0.75. Notably, only the 7.5Fr fURS ensured a safe IPP when combined with a 10/12F UAS. In clinical research, the sheath placement success rate was 100%, with an average operation time of 55.0 ± 20.0&#xa0;min and a lithotripsy time of 150.4 ± 199.0&#xa0;s. Mild ureteral injury necessitated the retention of a double-J stent in five cases for a month. The hospitalization duration and 24-h pain score averaged 45.6 ± 15.5&#xa0;h and 4.3 ± 3.5, respectively. The one-month stone-free rate was 91.3%. Regarding stent-related symptoms, the overactive bladder symptom score averaged 1.7 ± 1.5, the international prostate symptom score was 3.3 ± 2.8, and the quality of life was 1.3 ± 1.7.</p> Conclusions <p>Combining a 7.5Fr fURS with a 10/12Fr UAS is recommended as a secure option for treating renal calculi &lt; 2&#xa0;cm. Postoperative pain management is a future concern.</p>

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In-depth exploration and initial clinical practice of the ratio of endoscope-sheath diameter theory: smaller flexible ureteroscope with smaller ureteral access sheath

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月26日

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  • Haowen Gu,
  • Pengfei Qin,
  • Jian Shan,
  • Guohai Xie,
  • Jiasheng Hu,
  • Qiang Li,
  • Ting Huang,
  • Jingyu Shi,
  • Yue Cheng,
  • Zejun Yan,
  • Li Fang

摘要

Objectives

To assess the outcomes of combining a 7.5Fr flexible ureteroscope (fURS) with a 10/12F ureteral access sheath (UAS) through a comprehensive in vitro and in vivo evalu-ation.

Methods

We conducted a comparative analysis, evaluating the impact of a 7.5Fr fURS in contrast to others on in trapelvic pressure (IPP) and perfusion fluid flow rate (PFFR) in vitro. This assessµent involved varying ratios of endoscope−sheath diaµeter (RESDs). Subsequently, we prospectively enrolled 23 patients with renal calculi <2 cm who underwent laser lithotripsy using the coµbination of a 7.5Fr fURS and a 10/12F UAS. The patients’ profiles, including preoperative, operative inforµation and postoperative coµplications, were recorded.

Results

In vitro experi-ments revealed that IPP and PFFR remained optimal when the RESDs were ≤ 0.75. Notably, only the 7.5Fr fURS ensured a safe IPP when combined with a 10/12F UAS. In clinical research, the sheath placement success rate was 100%, with an average operation time of 55.0 ± 20.0 min and a lithotripsy time of 150.4 ± 199.0 s. Mild ureteral injury necessitated the retention of a double-J stent in five cases for a month. The hospitalization duration and 24-h pain score averaged 45.6 ± 15.5 h and 4.3 ± 3.5, respectively. The one-month stone-free rate was 91.3%. Regarding stent-related symptoms, the overactive bladder symptom score averaged 1.7 ± 1.5, the international prostate symptom score was 3.3 ± 2.8, and the quality of life was 1.3 ± 1.7.

Conclusions

Combining a 7.5Fr fURS with a 10/12Fr UAS is recommended as a secure option for treating renal calculi < 2 cm. Postoperative pain management is a future concern.