Ureteral Access Sheaths
Accompanying the development of more modern endoscopes in the 1970s and 1980s were technologies developed to further facilitate retrograde access to the upper urinary tract. The ureteral access sheath (UAS) has proven to be a useful adjunct in ureteroscopy. By simplifying repeated access to the upper urinary tract, the UAS has been shown to streamline ureteroscopy and decrease operative time and cost. Furthermore, it has been associated with lower intrarenal pressures, decreased damage to operative equipment, and improved stone free rates following ureteroscopy. Studies have also shown that the rates of ureteral stricture are not increased with their use, even though they have been shown to reduce ureteral blood flow, and require the placement of a ureteral stent afterward. With their expanding use, surgeons are now utilizing this tool as an adjunct in the treatment of upper tract urothelial cell carcinoma. The objective of this chapter is to provide a review of the current literature available regarding the UAS. This chapter will specifically address UAS construction and physical properties, purported benefits, potential complications, and uses in treating upper urinary tract pathology.
KeywordsStone Free Rate Ureteral Stricture Outer Sheath Ureteral Dilation Ureteral Access Sheath
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