{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:14:36Z","timestamp":1792512876976,"version":"4.5.0"},"reference-count":28,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"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":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate the efficacy of combining a tip-bendable suction ureteral access sheath (S-UAS) with gravity-assisted positioning to improve stone-free rates (SFRs) in retrograde intrarenal surgery (RIRS) for upper urinary tract stones (UUTS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A multicenter retrospective cohort study was conducted across three urological centers from July 2023 to August 2024. A total of 369 patients with UUTS treated with RIRS using S-UAS were included. Patients were categorized into two groups based on surgical positioning: the \u00b120\u00b0 gravity-assisted position group and the standard lithotomy group. SFRs were classified into three grades: Grade A (no residual fragments on CT), Grade B (\u22642mm fragments), and Grade C (\u22644mm fragments). Key outcomes measured included immediate and 3-month SFR, operative time, and complication rates. Logistic regression analysis was used to identify factors associated with improved SFR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The \u00b120\u00b0 gravity-assisted position group showed a significantly higher immediate Grade-A (71.3%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      48.1%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) and Grade-B SFR (86.0%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      67.2%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) compared to the standard lithotomy group. This superiority in Grade-A SFR persisted at 3 months (76.0%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      49.6%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). The median operative time was shorter in the \u00b120\u00b0 gravity-assisted position group (67\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      71 minutes,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0032) and the frequency of stone basket use was lower in \u00b120\u00b0 gravity-assisted position. Multivariate analysis revealed that the lithotomy position was independently associated with a lower stone-free probability (adjusted odds ratio 0.36, 95% confidence interval 0.17\u20130.80;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.012). No significant differences were observed in complication rates between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The \u00b120\u00b0 gravity-assisted position improves immediate SFR in RIRS for UUTS, with shorter operative times. Combining gravity-assisted positioning with S-UAS is an effective strategy to optimize surgical outcomes in RIRS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/end.2025.0053","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T07:41:56Z","timestamp":1746171716000},"page":"525-531","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["A Novel \u00b120\u00b0 Gravity-Assisted Position for Tip-Bendable Suction Ureteral Access Sheath in Retrograde Intrarenal Surgery: A Multicenter Retrospective Study on Large Stone Management"],"prefix":"10.1177","volume":"39","author":[{"given":"Meng-Hua","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Urology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology, Beijing Daxing District Hospital of Integrated Chinese and Western Medicine, Beijing, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2731-3421","authenticated-orcid":false,"given":"Xin","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2017.04.001"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16179"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007044.pub4"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013445.pub2"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2020.09.011"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000521373"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euros.2024.10.014"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102724"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-023-04654-y"},{"issue":"2","key":"e_1_3_8_11_2","first-page":"135","article-title":"Hydronephrosis: Diagnosis, grading, and treatment","volume":"92","author":"Laquerre J","year":"2020","unstructured":"Laquerre J. Hydronephrosis: Diagnosis, grading, and treatment. Radiol Technol, 2020; 92(2):135\u2013151.","journal-title":"Radiol Technol"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.2373\/6\/S2724-6051.24.05961-5"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2022.0610"},{"key":"e_1_3_8_14_2","unstructured":"T\u00fcrk C Kt Petrik A Sarica K Straub M Seitz C. European Association of Urology Guidelines on Urolithiasis 2019 Update. Available from: https:\/\/uroweb.org\/wpcontent\/uploads\/EAU-Guidelines-on-Urolithiasis-2019.pdf [Last accessed: October10 2019]."},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-023-01347-x"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2022.0701"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000004258"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.69335"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-024-05013-1"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.4081\/aiua.2021.3.313"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/JCMA.0000000000000913"},{"key":"e_1_3_8_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-018-2455-8"},{"key":"e_1_3_8_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-023-04648-w"},{"key":"e_1_3_8_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/0300060520956833"},{"key":"e_1_3_8_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-025-02933-2"},{"key":"e_1_3_8_26_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11175128"},{"key":"e_1_3_8_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/17562872241232275"},{"key":"e_1_3_8_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2023.03.010"},{"key":"e_1_3_8_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-022-01126-0"}],"container-title":["Journal of Endourology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/end.2025.0053","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2025.0053","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2025.0053","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T20:16:40Z","timestamp":1777407400000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/end.2025.0053"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":28,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1089\/end.2025.0053"],"URL":"https:\/\/doi.org\/10.1089\/end.2025.0053","relation":{},"ISSN":["0892-7790","1557-900X"],"issn-type":[{"value":"0892-7790","type":"print"},{"value":"1557-900X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]}}}