{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:51:59Z","timestamp":1790952719461,"version":"4.1.0"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aktuelle Urol"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n               Purpose To investigate the relationship between failure to insert a ureteral access sheath (UAS) with inflammation and other clinical parameters in patients treated with flexible ureteroscopy for renal stones.<\/jats:p><jats:p>\n               Methods This study included patients who underwent flexible ureteroscopy for the treatment of renal stones in our centre between 2015 and 2020. Patients who underwent any surgical procedure on the ipsilateral ureter and had a history of spontaneous stone passage were excluded. Patients were divided into two groups based on UAS insertion success (group 1) or failure (group 2). Both groups were compared with a view to clinical characteristics, preoperative neutrophil, lymphocyte, monocyte and platelet counts and ratios of these counts, all being considered inflammatory markers. A multivariate logistic regression analysis was performed to determine the independent variables affecting UAS insertion success. <\/jats:p><jats:p>\n               Results There were 113 (59.1%) patients in group 1, while group 2 consisted of 78 (40.9%) patients. The rates of male gender, coronary artery disease and preoperative ipsilateral hydronephrosis were significantly higher in group 2, while platelet counts and platelet-lymphocyte ratios were significantly lower. Our analysis revealed four independent predictors for UAS insertion failure: female gender (odds ratio [OR]=2.1) increased the rate of UAS insertion success, while hydronephrosis (OR=1.6), low platelet counts and PLR increased the rate of UAS insertion failure (OR=0.99, OR=0.98, respectively). <\/jats:p><jats:p>\n               Conclusion Our results suggest that male gender and ipsilateral hydronephrosis are associated with increased UAS insertion failure. Although we found a relationship between relatively low platelet levels and UAS insertion failure, we think that further studies are needed to investigate this matter.<\/jats:p>","DOI":"10.1055\/a-1378-2495","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:10:50Z","timestamp":1640131850000},"page":"67-74","source":"Crossref","is-referenced-by-count":11,"title":["Failure of ureteral access sheath insertion in primary flexible ureteroscopy for renal stones: is there any relation with inflammation?"],"prefix":"10.1055","volume":"53","author":[{"given":"Abdullah Hizir","family":"Yavuzsan","sequence":"additional","affiliation":[{"name":"Urology, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan Levent","family":"Kirecci","sequence":"additional","affiliation":[{"name":"Urology, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musab","family":"Ilgi","sequence":"additional","affiliation":[{"name":"Urologie, KMG Klinikum Luckenwalde, Luckenwalde, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Semih","family":"Turk","sequence":"additional","affiliation":[{"name":"Urology, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerem","family":"Bursali","sequence":"additional","affiliation":[{"name":"Urology, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cumhur","family":"Yesildal","sequence":"additional","affiliation":[{"name":"Urology, University of Health Sciences Sultan 2. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet Tevfik","family":"Albayrak","sequence":"additional","affiliation":[{"name":"Urology, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huseyin Cihan","family":"Demirel","sequence":"additional","affiliation":[{"name":"Urology, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Sisli, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaya","family":"Horasanli","sequence":"additional","affiliation":[{"name":"Urology, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,12,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1038\/nrurol.2015.271","article-title":"Use of ureteral access sheaths in ureteroscopy","volume":"13","author":"AG Kaplan","year":"2016","journal-title":"Nat Rev Urol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1089\/089277904322836631","article-title":"Ureteral access sheath provides protection against elevated renal pressures during routine flexible ureteroscopic stone manipulation","volume":"18","author":"BK Auge","year":"2004","journal-title":"J Endourol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1089\/end.2012.0414","article-title":"Ureteral stents for impassable ureteroscopy","volume":"27","author":"SN Ambani","year":"2013","journal-title":"J Endourol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/j.urology.2008.07.055","article-title":"Construction-related differences seen in ureteral access sheaths: comparison of reinforced versus nonreinforced ureteral access sheaths","volume":"73","author":"JM Shields","year":"2009","journal-title":"Urology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1414","DOI":"10.1089\/end.2014.0215","article-title":"Predicting an effective ureteral access sheath insertion: a bicenter prospective study","volume":"28","author":"Y Mogilevkin","year":"2014","journal-title":"J Endourol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1016\/j.urology.2015.08.007","article-title":"The Difficult Ureter: Clinical and Radiographic Characteristics Associated With Upper Urinary Tract Access at the Time of Ureteroscopic Stone Treatment","volume":"86","author":"BR Viers","year":"2015","journal-title":"Urology"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1089\/end.2016.0304","article-title":"Defining the Rate of Primary Ureteroscopic Failure in Unstented Patients: A Multi-Institutional Study","volume":"30","author":"TW Fuller","year":"2016","journal-title":"J Endourol"},{"key":"ref8","first-page":"9389","article-title":"Preoperative factors associated with failure in unstented primary ureteroscopy for nephrolithiasis","volume":"25","author":"P Whelan","year":"2018","journal-title":"Can J Urol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1016\/j.urology.2014.06.029","article-title":"Accessing the difficult ureter and the importance of ureteroscope miniaturization: history is repeating itself","volume":"84","author":"SG Hubosky","year":"2014","journal-title":"Urology"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"7204","DOI":"10.18632\/oncotarget.23208","article-title":"Inflammatory responses and inflammation-associated diseases in organs","volume":"9","author":"L Chen","year":"2017","journal-title":"Oncotarget"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1038\/s41585-019-0228-9","article-title":"Urogenital tuberculosis - 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