Gu Haowen, Qin Pengfei, Shan Jian, Xie Guohai, Hu Jiasheng, Li Qiang, Huang Ting, Shi Jingyu, Cheng Yue, Yan Zejun, Fang Li
Department of Urology, Ningbo Clinical Research Center for Urological Disease, Zhejiang Engineering Research Center of Innovative technologies and diagnostic and therapeutic equipment for urinary system diseases, The First Affiliated Hospital of Ningbo University, Ningbo, 315010, China.
Department of Urology, Zhejiang Chinese Medical University Affiliated Jiaxing TCM Hospital, Jiaxing, 314001, China.
BMC Urol. 2025 May 26;25(1):138. doi: 10.1186/s12894-025-01823-6.
To assess the outcomes of combining a 7.5Fr flexible ureteroscope (fURS) with a 10/12F ureteral access sheath (UAS) through a comprehensive in vitro and in vivo evalu-ation.
We conducted a comparative analysis, evaluating the impact of a 7.5Fr fURS in contrast to others on in trapelvic pressure (IPP) and perfusion fluid flow rate (PFFR) in vitro. This assessµent involved varying ratios of endoscope-sheath diaµeter (RESDs). Subsequently, we prospectively enrolled 23 patients with renal calculi <2 cm who underwent laser lithotripsy using the coµbination of a 7.5Fr fURS and a 10/12F UAS. The patients' profiles, including preoperative, operative inforµation and postoperative coµplications, were recorded.
In vitro experi-ments revealed that IPP and PFFR remained optimal when the RESDs were ≤ 0.75. Notably, only the 7.5Fr fURS ensured a safe IPP when combined with a 10/12F UAS. In clinical research, the sheath placement success rate was 100%, with an average operation time of 55.0 ± 20.0 min and a lithotripsy time of 150.4 ± 199.0 s. Mild ureteral injury necessitated the retention of a double-J stent in five cases for a month. The hospitalization duration and 24-h pain score averaged 45.6 ± 15.5 h and 4.3 ± 3.5, respectively. The one-month stone-free rate was 91.3%. Regarding stent-related symptoms, the overactive bladder symptom score averaged 1.7 ± 1.5, the international prostate symptom score was 3.3 ± 2.8, and the quality of life was 1.3 ± 1.7.
Combining a 7.5Fr fURS with a 10/12Fr UAS is recommended as a secure option for treating renal calculi < 2 cm. Postoperative pain management is a future concern.
通过全面的体外和体内评估，评估7.5Fr可弯曲输尿管镜（fURS）与10/12F输尿管通路鞘（UAS）联合使用的效果。
我们进行了一项对比分析，评估7.5Fr fURS与其他输尿管镜相比对体外肾盂内压力（IPP）和灌注液流速（PFFR）的影响。该评估涉及不同的内镜-鞘直径比（RESDs）。随后，我们前瞻性纳入了23例肾结石<2 cm的患者，这些患者接受了使用7.5Fr fURS和10/12F UAS联合进行的激光碎石术。记录患者的资料，包括术前、手术信息和术后并发症。
体外实验表明，当RESDs≤0.75时，IPP和PFFR保持最佳。值得注意的是，只有7.5Fr fURS与10/12F UAS联合使用时能确保安全的IPP。在临床研究中，鞘置入成功率为100%，平均手术时间为55.0±20.0分钟，碎石时间为150.4±199.0秒。5例出现轻度输尿管损伤，需要留置双J支架一个月。住院时间和24小时疼痛评分平均分别为45.6±15.5小时和4.3±3.5。1个月的结石清除率为91.3%。关于支架相关症状，膀胱过度活动症状评分平均为1.7±1.5，国际前列腺症状评分为3.3±2.8，生活质量评分为1.3±1.7。
推荐将7.5Fr fURS与10/12Fr UAS联合作为治疗<2 cm肾结石的安全选择。术后疼痛管理是未来需要关注的问题。
