{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T15:29:03Z","timestamp":1778858943611,"version":"3.51.4"},"reference-count":37,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To convert suction pressure settings into practical, size\u2010specific operating limits for suction ureteric access sheaths (sUAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Using an 8.7\u2010F flexible ureteroscope with a standard 3.9\u2010F working channel, we measured irrigation inflow at various pressures with no instrument, 270\u2010\u03bcm laser fibre, and 1.9\u2010F basket. Outflow was measured using 10\/12\u2010, 11\/13\u2010, and 12\/14\u2010F sUAS with suction applied via Neptune 3\u2122 (Stryker, Kalamazoo, MI, USA) at 30\u2010s intervals and pressures ranging from 50 to 300\u2009mmHg. Inflow and outflow were matched by linear interpolation deriving conservative size\u2010 and instrument\u2010specific suction pressure limits for all evaluated sUAS configurations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ureteroscope irrigation inflow ranged from 30 to 130\u2009mL\/min as irrigation pressure irrigation increased from 50\u2009cmH\n                      <jats:sub>2<\/jats:sub>\n                      0 (gravity) to 300\u2009mmHg. Working channel instruments reduced inflow: mean (\u00b1\u20092\u2009\u00d7\u2009the standard error of the mean) change of \u221257.1%\u2009(1.6%) for the 1.9\u2010F basket and \u221242.1%\u2009(2.1%) for the 270\u2010\u03bcm laser fibre vs no instrument. Negative pressure via sUAS generated outflow as slow as 5\u2009mL\/min (10\/12\u2010F sUAS, 50\u2009mmHg suction) and as fast as 700\u2009mL\/min (12\/14\u2010F sUAS, 300\u2009mmHg suction). Outflow and negative pressure were linearly related (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      0.94\u20130.99). Increased scope\u2010to\u2010sheath ratio (SSR) reduced irrigation outflow. Fully opening the valve significantly reduced outflow by 70.8% on average. The 40\u2010cm sUAS modestly increased outflow by 13.3% on average compared to 50\u2010cm sUAS of same diameter. Suction of 50\u201380\u2009mmHg was ideal for maintaining flow equilibrium with 11\/13\u2010 and 12\/14\u2010F sUAS. The small diameter and high SSR (0.87) of the 10\/12\u2010F sUAS required greater negative pressures (150\u2013300\u2009mmHg) to maintain flow equilibrium.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Suction pressures as low as 50\u201380\u2009mmHg are sufficient for majority of sUAS cases. Increasing irrigation inflow with pressure bag systems may counter excessive sUAS outflow; however, introducing instruments can negate this effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70012","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T10:13:43Z","timestamp":1758795223000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Safe pressures for suction ureteric access sheaths:\n                    <i>in\u00a0vitro<\/i>\n                    conversion of pressures to flow"],"prefix":"10.1111","volume":"137","author":[{"given":"Jordan","family":"Santucci","sequence":"first","affiliation":[{"name":"Department of Urology Austin Health  Heidelberg Victoria 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