Study Finds No Link Between Ureteral Access Sheaths and Ureteral Lesions
In This Article
- There is a lack of data around the long-term risks of using ureteral access sheaths in the treatment of kidney stones
- Some studies have shown that ureteral access sheaths during ureteroscopy can cause ureteral lesions when too much force is applied
- Research led by Brian Eisner, MD, co-director of the Kidney Stone Program at Massachusetts General Hospital, shows no risk of ureteral lesions with the use of ureteral access sheaths four years post-procedure
The discussion surrounding the use of ureteral access sheaths to treat kidney stone patients has been polarizing. Some urologists today believe there is not enough data surrounding the risk of ureteral injury with the use of ureteral access sheaths. Some studies have shown that ureteral access sheaths during ureteroscopy can cause ureteral lesions when too much force is applied.
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With a lack of data surrounding this approach, researchers led by Brian Eisner, MD, urologist and co-director of the Kidney Stone Program at Massachusetts General Hospital, have conducted a study to determine if the use of ureteral access sheaths is linked to developing ureteral strictures after surgery. His team studied patients who had undergone ureteroscopy procedures using ureteral access sheaths, on an average of four years post-procedure. They studied 157 patients, each of whom received an abdominal imaging scan at their follow-up visit.
The results, covered in Urology Times, showed that no patients demonstrated persistent hydronephrosis, had undergone treatment for a ureteral stricture or displayed radiographic evidence of a stricture. These results were consistent regardless of sheath diameter, size of the kidney stone, length of operating time and gender.
With a relatively small sample size of 157 patients, Jose Eduardo Castro Matheus Rodrigues, a urology research student at Mass General, notes more studies are needed. The long-term risks of using ureteral access sheaths remain an area that Mass General urologists want to further explore. However, having medium-term follow-up data through this study is a critical first step in advancing the discussion.
Learn about the Kidney Stone Program at Mass General
Refer a patient to the Department of Urology