An Observational Study on Success of Ureteral Access Sheath Placement during Primary Retrograde Intra-Renal Surgery for Renal Stones

Abstract

Background: This study explores the effectiveness and challenges of ureteral access sheath (UAS) placement during retrograde intrarenal surgery (RIRS) for treating renal stones. This study aims to evaluate the success of ureteral access sheath (UAS) placement during primary retrograde intrarenal surgery (RIRS) for renal stones, with a focus on assessing both placement success and related complications and stone-free rates. Methods: This cross-sectional observational study was conducted over six months at M S Ramaiah Medical College, Bengaluru, India, focusing on patients aged 21 to 80 years with renal stones measuring 10 mm to 20 mm. The study evaluated UAS placement success, intraoperative stone-free rates. Data collection included demographics, stone characteristics, and surgical parameters. Statistical analysis employed descriptive and inferential methods. Results: Among 50 patients (52% female, 48% male), diabetes mellitus was present in 38%. Stones were primarily located in the upper calyx (42%). The UAS was utilized in 82% of cases, with 52% requiring dilatation. Intraoperative complete stone clearance occurred in 82% of procedures, and total intraoperative time was significantly prolonged in cases of complete stone clearance (p < 0.001). Conclusion: The study highlights the challenges of UAS placement in RIRS for renal stones in Indian patients, particularly concerning larger stone burdens and abnormal ureteral anatomy. Future approaches should focus on individualized strategies to optimize surgical outcomes and reduce complications.