Evidence map›Paper›PMID 40560463›Full record

ArticleWorld journal of urology2025

Flexible ureteroscopy for renal stones comparing non suction conventional UAS vs flexible and navigable suction ureteral access sheaths in a multicenter real-world experience. Is it finally time to bury the no suction ureteral access sheath? An EAU endourology analysis.

Giorgio Mazzon, Samyek Dewan, Maryam Rasheed, Shailesh Kulkarni, Davide Brusa, Francesco Fontana, Khi Yung Fong, Kemal Sarica, Yasser Abelraouf Farahat, Ben H Chew and 6 more

Abstract readMulticenter StudyComparative Study
PubMed Publisher
In one paragraph

Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. The future of endourology is now.World journal of urology · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Giorgio MazzonInstitute of Urology, University College Hospitals of London, London, UK. giorgiomazzon83@gmail.com.
Samyek DewanInstitute of Urology, University College Hospitals of London, London, UK.
Maryam RasheedDepartment of Urology, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK.
Shailesh KulkarniDepartment of Urology, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK.
Davide BrusaDepartment of Urology, Santissima Trinità Hospital, ASL Novara, Borgomanero, Italy.
Francesco FontanaDepartment of Urology, Santissima Trinità Hospital, ASL Novara, Borgomanero, Italy.
Khi Yung FongYong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Kemal SaricaDepartment of Urology, Medical School Biruni University, Istanbul, Turkey.
Yasser Abelraouf FarahatTanta University, Tanta, Egypt.
Ben H ChewDepartment of Urology, University of British Columbia, Vancouver, Canada.
Naeem BhojaniDivision of Urology, University of Montreal Hospital Center, Monreal, QC, Canada.
Steffi Kar Kei YuenS.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
Bhaskar SomaniDepartment of Urology, University Hospitals Southampton NHS Trust, Southampton, UK.
Simon ChoongInstitute of Urology, University College Hospitals of London, London, UK.
Daniele CastellaniUrology Unit, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy.
Vineet GauharDepartment of Urology, Ng Teng Fong Hospital, Singapore, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare peri- and postoperative outcomes of non-suction conventional ureteral access sheath (CUAS) versus flexible and navigable suction ureteral access sheaths (FANS) in retrograde intra-renal surgery (RIRS) for renal stones.

methodsIn this multicentric, real world, prospective study, 529 adult patients undergoing RIRS across 19 centers were enrolled between August 2023 and January 2024. Of these, 263 underwent RIRS using FANS and 265 with CUAS. After propensity score matching (PSM) for age, gender, and stone volume, 184 patients per group were match paired for analysis. Outcomes included stone-free rate (SFR), intraoperative parameters, and postoperative complications assessed within 30 days.

resultsPost-PSM, baseline characteristics were well-balanced. The FANS group demonstrated significantly longer lasing (17.94 vs. 15.28 min, p = 0.017) and ureteroscopy time (37.48 vs. 30.08 min, p < 0.001), but similar total surgical time. The use of stone retrieval baskets and postoperative stenting was significantly lower in the FANS group (p < 0.001). The 30 day stone free rate was significantly higher with FANS (98.9% vs. 89.1%, p < 0.001) and lower re-operation rates (16.3% vs. 71.0%, p = 0.009). The incidence of postoperative pain was significantly lower in the FANS group (0.0% vs. 14.1%, p < 0.001), potentially due to reduced calyceal overdistension and lower rates of ureteral stenting (70.7% vs. 99.5%, p < 0.001) The overall complications rates were low and comparable between groups.

conclusionsThe higher 30-day stone-free rate and lower reintervention rates with FANS suggest better outcomes over conventional UAS RIRS. The reduced use of baskets and accessories make FANS a useful intraoperative tool for those performing RIRS with access sheaths. Along with low postoperative pain and the absence of a need for postoperative stenting in select FANS patients collectively, these findings favor using FANS with appropriate training over CUAS.

Indexed as

Kidney CalculiUreteroscopesUreteroscopyEquipment DesignFemaleHumansMaleMiddle AgedPostoperative ComplicationsProspective StudiesSuctionComplicationsFANSKidney stonesRetrograde Intra-Renal surgeryStone free rateUreteric access sheath

Identifiers

PMID40560463

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.