Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Feb 28;14(2):441-453.
doi: 10.21037/tau-24-557. Epub 2025 Feb 25.

Status study of clinical application of ureteral access sheath in urology: a narrative review

Changxiang Shu  1   2 , Jun Liu  1
Affiliations
Review

Status study of clinical application of ureteral access sheath in urology: a narrative review

Changxiang Shu et al. Transl Androl Urol. .

Abstract

Background and objective: As one of the effective minimally invasive methods for upper urinary tract stone treatment, ureteroscopic lithotripsy has gradually become the mainstream surgical approach. The routine use of ureteral access sheaths (UAS) during ureteroscopic lithotripsy has plenty of advantages. Although many concerns have emerged in the clinical practice of the UAS, the clinically improved devices have addressed these issues. This article reviews the advantages, existing issues, and current improvements of UAS in clinical practice, aiming to provide references for better clinical application and further improvements of UAS.

Methods: We searched in PubMed database using the terms: "ureteral access sheath", "ureteroscopic lithotripsy" or "flexible ureteroscope". Articles were independently evaluated for inclusion based on predetermined criteria.

Key content and findings: The routine use of UAS during ureteroscopic lithotripsy facilitates the entry and exit of the ureteroscope, improves intraoperative visibility, and reduces postoperative complications. However, concerns over ureteral wall injury, difficulty in controlling renal pelvic pressure, lack of reduction in operation time, failure to increase stone free rates, and controversies regarding the ratios of endoscope-sheath diameter have limited the clinical application of UAS. The emergence of clinically improved devices such as intelligent pressure controlled, tip bendable, and rigid ureteroscope aided UAS has addressed these issues, laying a foundation for their further clinical application.

Conclusions: The clinical improvement of the UAS can serve as a bridge for the widespread usage of the ureteroscopic lithotripsy. In the future, we anticipate more innovative advancements in UAS, making their clinical use even more practical and convenient.

Keywords: Upper urinary tract stones; stone free rate; ureteral access sheath (UAS); ureteroscopic lithotripsy.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-24-557/coif). Both authors report receiving funding from Peking University People’s Hospital Scientific Research Development Funds (No. RDE2023-11). The authors have no other conflicts of interest to declare.

Figures

Figure 1
Figure 1
Article screening and selection flowchart (6).
See this image and copyright information in PMC

References

    1. Kachkoul R, Touimi GB, El Mouhri G, et al. Urolithiasis: History, epidemiology, aetiologic factors and management. Malays J Pathol 2023;45:333-52. - PubMed
    1. Skolarikos A, Jung H, Neisius A, et al. EAU Guidelines on Urolithiasis. 2024. Edn. presented at the EAU Annual Congress Paris; 2024.
    1. Assimos D, Krambeck A, Miller NL, et al. Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II. J Urol 2016;196:1161-9. 10.1016/j.juro.2016.05.091 - DOI - PubMed
    1. Santa Cruz JAC, Danilovic A, Vicentini FC, et al. Ureteral access sheath. Does it improve the results of flexible ureteroscopy? A narrative review. Int Braz J Urol 2024;50:346-58. 10.1590/s1677-5538.ibju.2024.9907 - DOI - PMC - PubMed
    1. De Coninck V, Somani B, Sener ET, et al. Ureteral Access Sheaths and Its Use in the Future: A Comprehensive Update Based on a Literature Review. J Clin Med 2022;11:5128. 10.3390/jcm11175128 - DOI - PMC - PubMed

LinkOut - more resources