Evidence map›Paper›PMID 41805849›Full record

ArticleWorld journal of urology2026

The global flexible and navigable suction ureteral access sheaths (FANS) survey on utility, practices and future needs in flexible ureteroscopy: a EAU Endourology, PEARLS and IAU collaboration.

Steffi Kar Kei Yuen, Bhaskar Somani, Amelia Pietropaolo, Daniele Castellani, Wen Zhong, Wei Zhu, Arman Tsaturyan, Jia-Lun Kwok, Michael Wong, Tzevat Tefik and 11 more

Abstract read
In one paragraph

Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

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

21 authors.

Steffi Kar Kei YuenS.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China. steffiyuen@surgery.cuhk.edu.hk.
Bhaskar SomaniEuropean Association of Urology Section of Endourology (ESEUT), Arnhem, The Netherlands.
Amelia PietropaoloEuropean Association of Urology Section of Endourology (ESEUT), Arnhem, The Netherlands.
Daniele CastellaniEuropean Association of Urology Section of Endourology (ESEUT), Arnhem, The Netherlands.
Wen ZhongDepartment of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Wei ZhuDepartment of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Arman TsaturyanEuropean Association of Urology Section of Endourology (ESEUT), Arnhem, The Netherlands.
Jia-Lun KwokEuropean Association of Urology Section of Endourology (ESEUT), Arnhem, The Netherlands.
Michael WongDepartment of Urology, Singapore General Hospital, Singapore, Singapore.
Tzevat TefikDepartment of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
Yiloren TanidirDepartment of Urology, Medicana Atasehir Hospital, Istanbul, Türkiye, Turkey.
Satyendra PersaudDivision of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago.
Wissam KamalUrology Unit, King Fahd General Hospital, Jeddah, Saudi Arabia.
Boyke SoebhaliDepartment of Urology, Abdul Wahab Sjahranie Hospital Medical Faculty, Muliawarman University, Samarinda, Indonesia.
Deepak RagooriDepartment of Urology, Asian Institute of Nephrology & Urology, Irram Manzil Colony, Hyderabad, Telangana, India.
Mohamed ElshazlyUrology Unit, Menoufia University, Shibin el Kom, Egypt.
Anil ShresthaDepartment of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
Ben Hall ChewDepartment of Urology, University of British Columbia, Vancouver, Canada.
Chi-Fai NgS.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
Guohua ZengDepartment of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Vineet GauharEuropean Association of Urology Section of Endourology (ESEUT), Arnhem, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe landscape of flexible ureteroscopy (fURS) is evolving with the use of flexible and navigable suction ureteral access sheaths (FANS) as surgeons gain experience utilizing suction. Surveys offer a unique lens through which to evaluate the adoption, efficacy, and challenges associated with new endourology technology. As FANS become widespread, we aimed to capture real-world practice patterns of FANS utilization in fURS.

methodsA collaborative effort by the European Association of Urology (EAU), Progressive Endourological Association for Research and Leading Solutions (PEARLS) and International Alliance of Urolithiasis (IAU) lead to the design and dissemination of a 41-question survey via SurveyMonkey and social media from 19 April to 29 May 2025. Participation was voluntary. Descriptive statistics were applied to demographic details and categorical responses.

resultsA total of 680 participants had completed the questionnaire. The majority of respondents were endourology fellowship-trained consultants (71.8%) practicing in teaching hospitals. Overall, 91% of urologists used suction in fURS, with 28.7% having replaced all conventional sheaths with FANS. The most common indications included multiple renal stones, stones 1–2 cm in diameter, and bilateral stones. Key technical challenges included suction-induced pelvicalyceal system collapse (51.9%) and lower pole access (37.6%). Notably, 39.9% were unaware of their irrigation flow rates, and 28.1% did not know suction pressure settings. Low-power Holmium laser with a dusting-fragmentation-aspiration strategy was preferred. Future development priorities included defining irrigation/suction parameters (29.6%) and integrating pressure control mechanisms (25.9%).

conclusionThis survey highlights the rapid global adoption of FANS and its expanding role in complex stone management. Despite its perceived benefits in stone clearance and infection reduction, significant technical variability and knowledge gaps persist, underscoring the need for standardized protocols, structured training, and further technological innovation to optimize clinical implementation.

Indexed as

Practice Patterns, Physicians'UreteroscopesUreteroscopyEquipment DesignHumansSuctionSurveys and QuestionnairesUrologyFlexible and navigable suction ureteral access sheathFlexible ureteroscopySuctionSurveyUrolithiasis

Identifiers

PMID41805849
PMCPMC12975862

What Socratic holds

Textmetadata
LicenceCC BY
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.