{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T21:14:07Z","timestamp":1793913247040,"version":"4.8.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Retrograde intrarenal surgery (RIRS) is a widely used minimally invasive technique for renal stone management. Recently, flexible navigable vacuum-assisted ureteral access sheaths (FV-UASs) have been introduced to enhance RIRS outcomes. This study aimed to evaluate the efficacy of FV-UAS compared with traditional UAS (T-UAS) in RIRS, with a specific focus on the impact of hydronephrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A retrospective multicenter study was conducted involving 207 patients undergoing RIRS for renal stones. Patients were divided into two groups based on the type of UAS used: FV-UAS (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 105) or T-UAS (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 102). Demographic data, stone characteristics, operative time, complications, and stone-free rates (SFRs) were analyzed. The degree of hydronephrosis was assessed using the Society of Fetal Urology grading system.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The FV-UAS group demonstrated significantly shorter operative times (median: 50 minutes\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      57.5 minutes,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.039) and a higher SFR at 1-week postoperatively (47.6%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      23.5%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) compared with the T-UAS group. However, there was no significant difference in SFR at 1 month (75.2%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      68.6%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.290). Postoperative fever was significantly lower in the FV-UAS group (3.8%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      18.6%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.001). Importantly, the degree of hydronephrosis did not significantly impact the outcomes that performed RIRS with FV-UAS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>FV-UAS offers potential advantages over T-UAS in RIRS, including shorter operative times, improved early stone-free status, and reduced postoperative complications. Hydronephrosis did not appear to affect the efficacy of FV-UAS. These findings suggest that FV-UAS may be a valuable tool in optimizing RIRS outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/end.2024.0921","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T12:13:47Z","timestamp":1748607227000},"page":"646-651","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["A Comparative Study of Flexible Navigable Vacuum-Assisted Ureteral Access Sheath and Traditional Ureteral Access Sheath in Retrograde Intrarenal Surgery: Evaluating the Impact of Hydronephrosis on Stone-Free Rate and Complications"],"prefix":"10.1177","volume":"39","author":[{"given":"Ozgur","family":"Arikan","sequence":"first","affiliation":[{"name":"Department of Urology, Istanbul Medeniyet University, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erhan","family":"Erdogan","sequence":"additional","affiliation":[{"name":"Department of Urology, Health Sciences University, Prof. Dr. Ilhan Varank Education and Training Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Erhan","family":"Aydin","sequence":"additional","affiliation":[{"name":"Department of Urology, Eskisehir City Hospital, Eskisehir, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferhat Yakup","family":"Suceken","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Uslu","sequence":"additional","affiliation":[{"name":"Department of Urology, Kafkas University, Kars, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayberk","family":"Iplikci","sequence":"additional","affiliation":[{"name":"Department of Urology, Istanbul Medeniyet University, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre Burak","family":"Sahinler","sequence":"additional","affiliation":[{"name":"Department of Urology, Health Sciences University, Prof. Dr. Ilhan Varank Education and Training Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cahit","family":"Sahin","sequence":"additional","affiliation":[{"name":"Department of Urology, Health Sciences University, Prof. Dr. Ilhan Varank Education and Training Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asif","family":"Yildirim","sequence":"additional","affiliation":[{"name":"Department of Urology, Istanbul Medeniyet University, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kemal","family":"Sarica","sequence":"additional","affiliation":[{"name":"Department of Urology, Health Sciences University, Prof. Dr. Ilhan Varank Education and Training Hospital, Istanbul, Turkey."},{"name":"Department of Urology, Biruni University, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002331"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13828"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-016-0647-6"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2016.05.091"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.11.111"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007044.pub4"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2022.04.004"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13041114"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-024-01544-9"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.2203\/7\/uj.v0i0.4124"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.4111\/icu.20200526"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14101034"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/17562872241232275"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12082815"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-023-01341-3"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2017.04.007"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2016.0411"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-018-2455-8"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/9354714"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-023-04648-w"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2024.0076"},{"issue":"2","key":"e_1_3_5_24_2","first-page":"194","article-title":"The effect of hydronephrosis grade on stone-free rate in retrograde intrarenal stone surgery with flexible ureterorenoscopy","volume":"9","author":"Ergani B","year":"2021","unstructured":"Ergani B, , Ozbilen MH, , Yalc\u0131n MY, et al. The effect of hydronephrosis grade on stone-free rate in retrograde intrarenal stone surgery with flexible ureterorenoscopy. 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