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The following is a summary of “Enhanced stone-free rates with suctioning ureteral access sheath vs. traditional sheath in retrograde intrarenal surgery: a systematic review and meta-analysis,” published in the April 2025 issue of BMC Urology by Gonçalves et al. 

Flexible ureteroscopic lithotripsy (fURL) is a standard treatment for nephrolithiasis. Suctioning ureteral access sheath (S-UAS) may improve outcomes by aiding stone clearance. 

Researchers conducted a retrospective study to compare suctioning vs. traditional ureteral access sheaths in retrograde intrarenal surgery. 

They conducted a systematic review across multiple databases for trials comparing S-UAS with trials comparing S-UAS with traditional (T-UAS) in retrograde intrarenal surgery (RIRS). The primary endpoint was stone-free rate (SFR); secondary outcomes included adverse effects; operative time, fever rate, and hospital stay. 

The results showed 8 articles with 2,255 patients (978 S-UAS, 1,247 T-UAS). SFR was higher in the S-UAS group at 1 day (OR 3.79; 95% CI 1.70–8.46; P = 0.001; I² = 89.2%) and at 1–3 months (OR 1.98; 95% CI 1.52–2.59; P < 0.001; I² = 0%). S-UAS had fewer complications (OR 0.37; 95% CI 0.26–0.51; P < 0.001; I² = 0%), lower fever rate (OR 0.34; 95% CI 0.24–0.48; P < 0.001; I² = 0%), and shorter hospital stay (MD -0.11; 95% CI -0.16 to -0.05; P < 0.001; I² = 39.6%). No difference in operative time (MD -2.49; 95% CI -7.62–2.65; P = 0.343; I² = 88.3%). 

Investigators found that using S-UAS in RIRS enhanced SFR and reduced complications and hospital stay. 

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-025-01775-x