Can flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS-UAS) minimize postoperative double J stent placement? Results from a propensity score-matched analysis of 540 patients of the European Association of Urology Section of Endourology and global FANS collaborative study group
Purpose: To evaluate whether using flexible and navigable suction ureteral access sheath can obviate insertion of double J stent and establish the safety of overnight ureteric catheter placement as alternative following flexible ureteroscopy for kidney stones. Materials and Methods: Five hundred fo...
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| Format: | Article |
| Language: | English |
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Korean Urological Association
2025-05-01
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| Series: | Investigative and Clinical Urology |
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| Online Access: | https://www.icurology.org/pdf/10.4111/icu.20250071 |
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| author | Daniele Castellani Bhaskar Kumar Somani Khi Yung Fong Steffi Kar Kei Yuen Chin Tiong Heng Mohamed Elshazly Karl Tan Thomas R. W. Herrmann Olivier Traxer Vineet Gauhar |
| author_facet | Daniele Castellani Bhaskar Kumar Somani Khi Yung Fong Steffi Kar Kei Yuen Chin Tiong Heng Mohamed Elshazly Karl Tan Thomas R. W. Herrmann Olivier Traxer Vineet Gauhar |
| author_sort | Daniele Castellani |
| collection | DOAJ |
| description | Purpose: To evaluate whether using flexible and navigable suction ureteral access sheath can obviate insertion of double J stent and establish the safety of overnight ureteric catheter placement as alternative following flexible ureteroscopy for kidney stones.
Materials and Methods: Five hundred forty adults were prospectively enrolled across 25 centers (from April 2023 to January 2024). Patients were divided into group 1 (overnight ureteric catheter), and group 2 (double J stent). Surgeons could choose either modality as per their discretion. One-to-one propensity score-matching for age, sex, pre-stenting, Hounsfield units, stone volume and location was performed. Thirty-day computed tomography scan was done to estimate stone-free status.
Results: After matching, 120 patients were included in each group. Group 1 had significantly shorter lasing, ureteroscopy, surgical time. Median day 1 loin pain score was similar (1 [1, 2] in both groups). Median postoperative stay was shorter in group 1 (0 days [0, 1] vs. 1 day [0, 2], p<0.001). One patient in group 2 required a blood transfusion. Incidence of fever was similar (5.0% vs. 0.8%). Loin/abdominal pain requiring medication occurred in one patient in group 2. Stent-related symptoms occurred in 2 patients in group 1. Three patients (2.5%) in group 1 and 2 patients (1.7%) in group 2 required readmission. Thirty-day stone-free status was higher in group 1 patients (79.2% vs. 56.7%).
Conclusions: In selected patients after thorough inspection to ensure no injury or residual fragments remain, placing an overnight ureteric catheter can be a safe alternative to a double J stent. |
| format | Article |
| id | doaj-art-1c107c2d78ea421dad5f4c5e24e95ade |
| institution | Kabale University |
| issn | 2466-0493 2466-054X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Korean Urological Association |
| record_format | Article |
| series | Investigative and Clinical Urology |
| spelling | doaj-art-1c107c2d78ea421dad5f4c5e24e95ade2025-08-20T03:53:12ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2025-05-0166323624410.4111/icu.20250071Can flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS-UAS) minimize postoperative double J stent placement? Results from a propensity score-matched analysis of 540 patients of the European Association of Urology Section of Endourology and global FANS collaborative study groupDaniele Castellani0https://orcid.org/0000-0001-7354-9190Bhaskar Kumar Somani1https://orcid.org/0000-0002-6248-6478Khi Yung Fong2https://orcid.org/0000-0001-8194-0800Steffi Kar Kei Yuen3https://orcid.org/0000-0002-9956-1558Chin Tiong Heng4https://orcid.org/0000-0001-7925-1176Mohamed Elshazly5https://orcid.org/0000-0003-2331-2915Karl Tan6https://orcid.org/0000-0001-6870-2808Thomas R. W. Herrmann7https://orcid.org/0000-0003-4493-1301Olivier Traxer8https://orcid.org/0000-0002-2459-3803Vineet Gauhar9https://orcid.org/0000-0002-3740-7141Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy.Department of Urology, University Hospitals Southampton, NHS Trust, Southampton, UK.Yong Loo Lin School of Medicine, National University of Singapore, Singapore.SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong.Department of Urology, Ng Teng Fong General Hospital, Singapore.Urology Unit, Menoufia University, Shibin el Kom, Egypt.Department of Surgery, Section of Urology, Veterans Memorial Medical Center, Quezon City, Philippines.Spital Thurgau AG (STGAG), Frauenfeld, Switzerland.Department of Urology, Tenon Hospital, AP-HP Sorbonne University, Paris, France.Department of Urology, Ng Teng Fong General Hospital, Singapore.Purpose: To evaluate whether using flexible and navigable suction ureteral access sheath can obviate insertion of double J stent and establish the safety of overnight ureteric catheter placement as alternative following flexible ureteroscopy for kidney stones. Materials and Methods: Five hundred forty adults were prospectively enrolled across 25 centers (from April 2023 to January 2024). Patients were divided into group 1 (overnight ureteric catheter), and group 2 (double J stent). Surgeons could choose either modality as per their discretion. One-to-one propensity score-matching for age, sex, pre-stenting, Hounsfield units, stone volume and location was performed. Thirty-day computed tomography scan was done to estimate stone-free status. Results: After matching, 120 patients were included in each group. Group 1 had significantly shorter lasing, ureteroscopy, surgical time. Median day 1 loin pain score was similar (1 [1, 2] in both groups). Median postoperative stay was shorter in group 1 (0 days [0, 1] vs. 1 day [0, 2], p<0.001). One patient in group 2 required a blood transfusion. Incidence of fever was similar (5.0% vs. 0.8%). Loin/abdominal pain requiring medication occurred in one patient in group 2. Stent-related symptoms occurred in 2 patients in group 1. Three patients (2.5%) in group 1 and 2 patients (1.7%) in group 2 required readmission. Thirty-day stone-free status was higher in group 1 patients (79.2% vs. 56.7%). Conclusions: In selected patients after thorough inspection to ensure no injury or residual fragments remain, placing an overnight ureteric catheter can be a safe alternative to a double J stent.https://www.icurology.org/pdf/10.4111/icu.20250071kidney calculilithotripsy lasersuctionureteroscopy |
| spellingShingle | Daniele Castellani Bhaskar Kumar Somani Khi Yung Fong Steffi Kar Kei Yuen Chin Tiong Heng Mohamed Elshazly Karl Tan Thomas R. W. Herrmann Olivier Traxer Vineet Gauhar Can flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS-UAS) minimize postoperative double J stent placement? Results from a propensity score-matched analysis of 540 patients of the European Association of Urology Section of Endourology and global FANS collaborative study group Investigative and Clinical Urology kidney calculi lithotripsy laser suction ureteroscopy |
| title | Can flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS-UAS) minimize postoperative double J stent placement? Results from a propensity score-matched analysis of 540 patients of the European Association of Urology Section of Endourology and global FANS collaborative study group |
| title_full | Can flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS-UAS) minimize postoperative double J stent placement? Results from a propensity score-matched analysis of 540 patients of the European Association of Urology Section of Endourology and global FANS collaborative study group |
| title_fullStr | Can flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS-UAS) minimize postoperative double J stent placement? Results from a propensity score-matched analysis of 540 patients of the European Association of Urology Section of Endourology and global FANS collaborative study group |
| title_full_unstemmed | Can flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS-UAS) minimize postoperative double J stent placement? Results from a propensity score-matched analysis of 540 patients of the European Association of Urology Section of Endourology and global FANS collaborative study group |
| title_short | Can flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS-UAS) minimize postoperative double J stent placement? Results from a propensity score-matched analysis of 540 patients of the European Association of Urology Section of Endourology and global FANS collaborative study group |
| title_sort | can flexible ureteroscopy using flexible and navigable suction ureteral access sheath fans uas minimize postoperative double j stent placement results from a propensity score matched analysis of 540 patients of the european association of urology section of endourology and global fans collaborative study group |
| topic | kidney calculi lithotripsy laser suction ureteroscopy |
| url | https://www.icurology.org/pdf/10.4111/icu.20250071 |
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