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Ureteral Access Sheath

Endoscopic adjunct for flexible ureteroscopy.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Ureteral Access Sheath?

Ureteral access sheath is a hydrophilic-coated tubular device placed over a guidewire from the urethra into the ureter, providing a working channel for repeated insertions of flexible ureteroscope and laser fibers during retrograde intrarenal surgery (RIRS) for kidney stones.

Sheath sizes range from 9.5/11.5 Fr to 14/16 Fr. UAS reduces intrarenal pressure, improves visualization with continuous irrigation outflow, shortens operative time and facilitates fragment retrieval, but carries risks of ureteral injury (PULS classification).

Symptoms

Renal colic from obstructive nephrolithiasis
Recurrent urinary tract infection due to stones
Hematuria with stone burden
Hydronephrosis on imaging with stones
Failed shock-wave lithotripsy

Risk Factors

Stone size 1-2 cm (RIRS preferred indication)
Multiple lower-pole calyceal stones
Coagulopathy precluding PCNL
Anatomical anomaly (horseshoe kidney, calyceal diverticulum)
Failed extracorporeal shock-wave lithotripsy
Pediatric or solitary kidney stone disease

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Symptomatic kidney stone above 1 cm
  • Persistent stone after multiple SWL sessions
  • Stone in lower-pole calyx with unfavorable anatomy
  • Bilateral kidney stones requiring single-session treatment
  • Stone in transplanted or solitary kidney

Treatment Methods

01
Pre-stenting in difficult ureter for passive dilation (1-2 weeks)
02
Atraumatic UAS placement under fluoroscopic and tactile guidance
03
Choice of size 11/13 Fr or 12/14 Fr balancing flow and ureteral safety
04
Avoidance of forceful insertion to prevent ureteral injury
05
Holmium-YAG or thulium fiber laser stone fragmentation through UAS
06
Post-procedure ureteral inspection and PULS grading
07
Routine ureteral stent placement based on operative findings

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.