Does Use of Ureteral Access Sheath Lower Postoperative Infection Rates After Flexible Ureteroscopic Stone Management ? – a Critical Evaluation

Author:

Asik Alper1,Erdogan Erhan1,Suceken Ferhat Yakup2,Aydin Mehmet Erhan3,Uslu Mehmet4,Bicaklioglu Fatih5,Sehinler Emre Burak1,Sarica Kemal1

Affiliation:

1. Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital

2. Umraniye Training and Research Hospital

3. Eskisehir City Hospital

4. Kafkas University Medical School

5. Dr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi

Abstract

Abstract

Aim : To evaluate the possible impact of ureteral access sheath (UAS) usage on the infectious complications following flexible ureteroscopy (fURS) Patients and methods : A total of 93 cases with solitary kidney stones (<15 mm) underwent fURS. To evaluate the possible effect of UAS use on the infectious complications after the procedures, cases were divided into two groups based on the use of UAS as; Group 1 (n: 51) cases treated with UAS and Group 2 (n: 42) cases treated without UAS during fURS. Following the stone management, treatment parameters and follow-up data were evaluated regarding the success rates, complications with an emphasis on infective onesandthe need for urgent admission rates were comparatively evaluated in both groups. Results: While the mean age of the cases was 48,2 years, mean stone size was 11,89 mm. The mean surgery time was 56.03 ± 13.17 minutes and the overall stone free rate(SFR) was 88.2%. Mean age value, body mass index, and mean degree of hydronephrosis did not significantly differ in both groups. Similarly, mean stone size, stone number and stone density were similar in both groups (p=0.79, p=0.43, and p:0.99, respectively).Although the operative time was shorter in cases operated with UAS, as an advantage,infectivecomplications were found to be significantly higher in these cases (p=0.021). However, peroperative complications were found to be higher in cases operated without an access sheath during fURS. Conclusions : Our results clearly demonstrated that although the use of UAS may shorten the operative time as an advantage, this application may not have a meaningful effect on the incidence of infective complications after flexible ureteroscopic stone management.

Publisher

Springer Science and Business Media LLC

Reference23 articles.

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2. Clinical characteristics of postoperative febrile 8 Journal of International Medical Research urinary tract infections after ureteroscopic lithotripsy;Kim JW;Investig Clin Urol,2018

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4. Levy MM, Fink MP, Marshall JC et al (2003) 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med. ; 31: 1250–1256

5. Fiber optics in urology;Marshall VF;J Urol,1964

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