Evidence map›Paper›PMID 41964793›Full record

ArticleWorld journal of urology2026

Pressure and sheath settings in a flexible suction ureteral access sheath: in-vitro assessment for retrograde intrarenal surgery.

Sang Won So, Jose Carlo R Elises, Fahad Alzahrani, Omar Sulaiman, Hyomyoung Lee, Paul R Villegas, Ching-Heung Yen, Mohammed Almujhim, Sung Yong Cho

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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. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

9 authors.

Sang Won SoDepartment of Urology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Jose Carlo R ElisesDivision of Urology, Department of Surgery, University of the Philippines - Philippine General Hospital, Manila, Philippines.
Fahad AlzahraniDepartment of Urology, East Jeddah Hospital, Jeddah, Saudi Arabia.
Omar SulaimanDepartment of Urology, King Fahd General Hospital, Jeddah, Saudi Arabia.
Hyomyoung LeeDepartment of Urology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Paul R VillegasDepartment of Urology, Cebu South Medical Center, Cebu, Philippines.
Ching-Heung YenDivision of Urology, Department of Surgery, Tri-service General Hospital SongShan Branch, Taipei, Taiwan.
Mohammed AlmujhimDepartment of Urology, King Faisal University, Alahssa, Saudi Arabia.
Sung Yong ChoDepartment of Urology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. moretry@snu.ac.kr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo determine recommendable settings of irrigation pressure, suction pressure, and the ratio of endoscope-sheath diameter (RESD) for safe and efficient stone removal when using a flexible and navigable suction ureteral access sheath (FANS-UAS) in retrograde intrarenal surgery (RIRS).

methodsAn ex vivo porcine kidney model with an artificial calcium oxalate stone was used. Different RESD values (0.68, 0.75, 0.86, and 0.95) were evaluated under different combinations of irrigation pressure (100, 200, and 300 mmHg) and suction pressure (100, 200, 300, and 400 mmHg). Stone pull-out time (POT), measured ten times for each setting to compare stone removal efficiency, was the primary endpoint. Intrarenal pressure (IRP), measured for 1 min with a safety cutoff value of 30 mmHg, was the safety endpoint.

resultsHigher irrigation pressure significantly shortened stone POT (p < 0.05), with strongest correlation at RESD 0.75. In contrast, suction pressure over 200 mmHg improved POT versus 100mmHg but showed no graded benefit beyond 200mmHg. At matched settings, POT was generally shorter at RESD 0.86 than 0.75. IRP remained under 30 mmHg across most pressure combinations at RESD 0.68, 0.75, and 0.86, while exceeded safe levels at RESD 0.95 with irrigation pressure over 200 mmHg.

conclusionFor faster stone removal using FANS-UAS, increasing irrigation pressure with proper RESD is crucial. Also, maintaining appropriate suction pressure is important to keep safe IRP range. These results provide recommendable in-vitro guidance to balance efficiency and IRP control when using FANS-UAS in RIRS.

Indexed as

Kidney CalculiAnimalsEquipment DesignIn Vitro TechniquesPressureSuctionSwineTherapeutic IrrigationUreterFlexible and navigable suction ureteral access sheathIntrarenal pressureIrrigationPull-out timeRatio of endoscope-sheath diameterRIRSSuction

Identifiers

PMID41964793

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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.