Ureteral Access Sheath Applicatıon Without Fluoroscopy in Retrograde Intrarenal Surgery.

OBJECTIVE: To compare the results and complications of the two techniques of ureteral access sheath application, with and without using fluoroscopy.

STUDY DESIGN: A comparative study.

PLACE AND DURATION OF STUDY: Department of Urology, Karabuk University Medical Faculty Training and Research Hospital and Ankara Diskapi Yildirim Beyazid Training and Research Hospital between April 2014 and January 2018.

METHODOLOGY: Retrospective evaluation was made of patients applied with retrograde intrarenal surgery using ureteral access sheath (UAS). In Group 1, defined method were used for UAS application without using scopy. In Group 2, following semi-rigid ureterorenoscopy, localisation of guidewire was checked with fluoroscopy. UAS was advanced to ureter over guidewire under fluoroscopy imaging.

RESULTS: Success rate of UAS placement was similar in both groups (p=0.747). The time of UAS placement was 14.75 secs in Group 1 and 14.99 secs in group 2 (p=0.073). Fluoroscopy was not used at all during UAS placement in Group 1. In Group 2, the mean duration of fluoroscopy use was 9.93±3.89 secs. Total stone-free rate was 82.09% and 83.28% in Group 1 and 2, respectively. (p=0.653).

CONCLUSION: The method described in this paper provides protection against radiation exposure for both the patient and the operating team; and prevents potential complications by enabling clear evaluation of ureteral orifice. Key Words: Renal stone surgery, Retrograde ıntrarenal surgery, Radiation protection, Flouroscopy, Radiation free.