Use of ureteral access sheaths in ureteroscopy.

Published

Journal Article (Review)

The ureteral access sheath (UAS) facilitates the use of flexible ureteroscopy, enabling improved minimally invasive management of complex upper urinary tract diseases. The UAS, which comes in a variety of diameters and lengths, is passed in a retrograde fashion, aided by a hydrophilic coating and other features designed to confer smooth passage into the ureter with sufficient resistance to kinking and buckling. Use of a UAS has the advantage of enabling repeated passage of the ureteroscope while minimizing damage to the ureter, thus improving the flow of irrigation fluid and visualization within the urethra with reductions in operative times, which improves both the effectiveness of the surgery and reduces the costs. Placement of the UAS carries an increased risk of ureteral wall ischaemia and injury to the mucosal or muscular layers of the ureter, and a theoretically increased risk of ureteral strictures. A ureteral stent is typically placed after ureteroscopy with a UAS. Endourologists have found several additional practical uses of a UAS, such as the percutaneous treatment of patients with ureteral stones, and solutions to other endourological challenges.

Full Text

Duke Authors

Cited Authors

  • Kaplan, AG; Lipkin, ME; Scales, CD; Preminger, GM

Published Date

  • March 2016

Published In

Volume / Issue

  • 13 / 3

Start / End Page

  • 135 - 140

PubMed ID

  • 26597613

Pubmed Central ID

  • 26597613

Electronic International Standard Serial Number (EISSN)

  • 1759-4820

International Standard Serial Number (ISSN)

  • 1759-4812

Digital Object Identifier (DOI)

  • 10.1038/nrurol.2015.271

Language

  • eng