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Ureteroscopic Access: Sheaths, Balloons, and Wireless Approaches

  • Sara L. BestEmail author
Chapter

Abstract

There exist a variety of techniques to obtain access to the ureter and renal collecting system during ureteroscopy. The initial steps involve retrograde insertion of one or more “working” wires through the ureter to coil in the renal pelvis. Several types of wires are available to help negotiate obstructing stones or tortuous segments. A second “safety” wire is typically placed to facilitate repeat access to the collecting system. After wire placement, a semirigid ureteroscope can be passed directly into the ureter or a flexible ureteroscope can be passed over a working wire, Seldinger-fashion. A number of devices exist to provide ureteral dilation, should this be necessary. In some cases, a ureteral access sheath may provide an advantage, easing repeated access to the ureter for stone fragment extraction and decreasing intrarenal pressures. Urologists should become comfortable with a variety of ureteral access techniques to maximize success in a wide range of clinical situations

Keywords

Renal Pelvis Fluoroscopic Guidance Ureteral Stone Distal Ureter Ureteral Orifice 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of UrologyUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA

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