{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:40:53Z","timestamp":1792428053895,"version":"4.5.0"},"reference-count":20,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Urol Int"],"abstract":"<jats:p>Introduction: The flexible and navigable suction ureteral access sheath (FANS-UAS) has expanded the indications for flexible ureteroscopic lithotripsy (fURL) to include upper urinary tract stones (UUTSs) measuring 2\u20133 cm. However, the impact of patient sex on surgical efficiency with this novel technique remains unknown. Methods: This single-center retrospective study enrolled 318 consecutive patients (210 males and 108 females) who underwent fURL with FANS-UAS for a solitary UUTS measuring 2\u20133 cm, between December 2024 and May 2026. Exclusion criteria included anatomical abnormalities and severe organ dysfunction. Baseline parameters, operative time (total and by phase), stone-free rates (SFRs) on postoperative day (POD) 1 and POD 30, and Clavien-Dindo complications were compared between sexes. Three general linear models (GLMs) were constructed to adjust for age, stone size, hydronephrosis, and other confounders, and to dissect the effect of sex on total operative time, fragmentation time, and fragment retrieval time. Results: Total operative time was significantly shorter in females than in males (63.4 \u00b1 15.0 vs. 79.9 \u00b1 21.4 min, p &lt; 0.01), driven predominantly by a marked reduction in fragment retrieval time (36.5 \u00b1 10.4 vs. 50.9 \u00b1 13.5 min, p &lt; 0.01), whereas fragmentation time did not differ significantly (17.8 \u00b1 5.7 vs. 18.4 \u00b1 5.9 min, p = 0.341). Immediate SFR (86.1% vs. 87.6%, p = 0.704) and follow-up SFR at POD 30 (91.7% vs. 90.0%, p = 0.831) were comparable, as were overall complication rates. GLM analysis confirmed female sex as the strongest independent predictor of shorter total operative time (B = \u221218.5, 95% CI: \u221221.6 to \u221215.4, F = 134.9, p &lt; 0.01) and fragment retrieval time (B = \u221215.6, 95% CI: \u221217.8 to \u221213.4, F = 191.1, p &lt; 0.01). Conclusion: Female patients undergoing fURL with FANS-UAS for UUTSs measuring 2\u20133 cm have significantly shorter operative times than males. Patient sex should be considered in preoperative counseling and surgical planning.<\/jats:p>","DOI":"10.1159\/uin\/aewag027","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T11:40:27Z","timestamp":1790941227000},"page":"1-1","source":"Crossref","is-referenced-by-count":0,"title":["Sex Disparity in Flexible Ureteroscopic Lithotripsy with Flexible and Navigable Suction Ureteral Access Sheath for 2- to 3-cm Upper Urinary Tract Stones: Shorter Operative Time in Female Patients"],"prefix":"10.1159","author":[{"given":"Junkai","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Bao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuanhao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songhao","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haijie","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2025.03.011"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-025-05489-5"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-026-06200-y"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2025.06.001"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-023-04595-6"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000002363"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0000000000001333"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1111\/bju.70367"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1177\/17562872261452324"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-026-06356-7"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13092493"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2023.05.032"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16844"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2016.172"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1590\/S1677-5538.IBJU.2017.0483"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102724"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16504"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000025182"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2021.718583"}],"container-title":["Urologia Internationalis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/uin\/aewag027","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:01:55Z","timestamp":1792425715000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/uin\/aewag027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":20,"URL":"https:\/\/doi.org\/10.1159\/uin\/aewag027","archive":["Portico"],"relation":{},"ISSN":["0042-1138","1423-0399"],"issn-type":[{"value":"0042-1138","type":"print"},{"value":"1423-0399","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,15]]}}}