Comparison of Flexible & Navigable Suction Ureteral Access Sheath vs. Antegrade Suction in Retrograde Flexible Ureteroscopy for Lower Calyceal Stones

Comparison Study Between Using Retrograde Flexible Ureteroscopy With Flexible & Navigable Suction Ureteral Access Sheath Versus Retrograde Flexible Ureteroscopy With Antegrade Suction in Lower Calyceal Stone: A Randomized Controlled Trial

This randomized controlled trial aims to compare the efficacy and safety of two suction techniques during retrograde flexible ureteroscopy (FURS) for lower calyceal renal stones measuring 1.5-2 cm. The study evaluates Flexible & Navigable Suction Ureteral Access Sheath (FANS) versus Antegrade Suction (via percutaneous access) in improving stone-free rates (SFR), reducing operative time, and minimizing complications such as bleeding, ureteral injury, and infection. A total of 120 adult patients will be randomized into two groups, undergoing either flexible ureteroscopy (FURS) with Flexible & Navigable Suction Ureteral Access Sheath (FANS) or flexible ureteroscopy (FURS) with antegrade suction, at Banha University Faculty of Medicine.

Inclusion Criteria:

• Adult patients (≥18 years old)
• Patients diagnosed with renal stones (1.5-2 cm) confirmed by non-contrast computed tomography (NCCT)
• Patients undergoing flexible ureteroscopy (FURS) as the primary treatment approach
• Patients with no active urinary tract infection (UTI) at baseline
• Patients who provide written informed consent

Exclusion Criteria:

• Patients with anatomical anomalies (e.g., horseshoe kidney, PUJ obstruction)
• Patients with a single functioning kidney
• Pregnant women
• Patients with a history of urological malignancy
• Patients with active bleeding disorders or those on anticoagulant therapy that cannot be safely discontinued
• Patients at high risk for anesthesia