{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T21:28:48Z","timestamp":1788643728368,"version":"build-2803163510"},"reference-count":13,"publisher":"S.C. JURNALUL PENTRU MEDICINA SI VIATA S.R.L","issue":"4","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMedLife"],"abstract":"<jats:p>Large meta-analyses demonstrated that ureteral access sheaths (UAS) have specific complications during and after flexible ureteroscopy (fURS). The present study focused on the technical aspects, advantages, drawbacks, and limitations of the latest \u201cno-touch\u201d technique (NTT) in the flexible ureteroscopic therapeutic approach of renal stones. A total of 288 patients with a single pyelocaliceal stone (largest diameter between 11 and 29 mm) underwent fURS: 144 using the 12\/14 Fr UAS (group 1) and 144 without UAS (group 2). For NTT, we used four types of ureteroscopes: Olympus URF-V2 (8.5 Fr) \u2013 33 cases, Storz Flex X2 (8.4 Fr) \u2013 60 cases, single-use PUSEN PU 3022 (9.5 Fr) \u2013 37 cases, and single-use PUSEN \u2013 PU 3033A (7.5 Fr) \u2013 14 cases. For group 1, we used the Olympus URF\u2013V2 ureteroscope in 44 cases, the Storz Flex X2 in 58 cases, and the single-use PUSEN PU 3022 in 42 cases. We compared the operative time, hospitalization periods, and complications. Successful access sheath insertion was noted in 83.3% of cases from group 1, and successful ureteroscope insertion was noted in 90.9% of cases from group 2. The average operative time was slightly higher in group 1 vs. group 2 (47 vs. 39 min). Stone-free rates (SFRs) were overall lower in group 2 (76.3% vs. 86.8%) at 1 month. At 3 months, we did not find a significant difference between these two groups. Superficial mucosal ureteral wall lesions were found in 38.8% of patients from group 1 and 4.1% from group 2. Hospitalization periods were longer in group 1 vs. group 2 (21 vs. 29 hours, respectively). The single-use 7.5 Fr ureteroscope should receive a special mention: the insertion was simple, we did not encounter any mucosal ureteral wall lesions, and all patients were discharged on the same day. Despite the clear advantages of routine UAS usage, there are many adverse events for the patient. Larger diameter sheaths involve a greater risk of ureteral wall injury. NTT seems to improve peri- and postoperative safety while preserving therapeutic efficiency. The new 7.5 Fr ureteroscopes appear to optimize surgical efficiency and diminish complications in the flexible ureteroscopic treatment of renal stones.<\/jats:p>","DOI":"10.25122\/jml-2021-0217","type":"journal-article","created":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T07:45:18Z","timestamp":1634283918000},"page":"481-486","source":"Crossref","is-referenced-by-count":8,"title":["The \u201cno-touch\u201d technique in the flexible ureteroscopic approach of renal stones"],"prefix":"10.25122","volume":"14","author":[{"given":"Bogdan","family":"Geavlete","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Sanador Hospital, Bucharest, Romania","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Urology, Sf. Ioan Emergency Clinical Hospital, Bucharest, Romania","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Bogdan Geavlete, MD, Department of Urology, Sf. Ioan Emergency Clinical Hospital, 13 Vitan-Barzesti Street, 042122, Bucharest, Romania. E-mail: bogdan_geavlete@yahoo.com","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosmin","family":"Cozma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Urology, Sf. Ioan Emergency Clinical Hospital, Bucharest, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petrisor","family":"Geavlete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Sanador Hospital, Bucharest, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Urology, Sf. Ioan Emergency Clinical Hospital, Bucharest, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10755","published-online":{"date-parts":[[2021,8]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Mar\u00eda Rodr\u00edguez-MonsalveHerrero, Steeve Doizi, Etienne Xavier Keller et al. Retrograde intrarenal surgery: An expanding role in treatment of urolithiasis. Asian J Urol. 2018 Oct; 5(4): 264\u2013273. doi: 10.1016\/j.ajur.2018.06.005.","DOI":"10.1016\/j.ajur.2018.06.005"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Victor K.F. Wong,KhaterehAminoltejari, Khaled Almutairi et al. Controversies associated with ureteral access sheath placement during ureteroscopy. InvestigClin Urol. 2020 Sep; 61(5): 455\u2013463. doi: 10.4111\/icu.20200278. This article shows that if ureteral wall injury occurs during ureteroscopy due to a UAS placement, stenting post-operatively has been shown to play a reparatory role in the prevention of ureteral edema and directly minimizes pain secondary to residual stone fragments and blood clots.","DOI":"10.4111\/icu.20200278"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Traxer O, Wendt-Nordahl G, Sodha H et al. Differences in renal stone treatment and outcomes for patients treated either with or without the support of a ureteral access sheath: the Clinical Research Office of the Endourological Society Ureteroscopy Global Study. World J Urol. 2015;33:2137\u20132144.","DOI":"10.1007\/s00345-015-1582-8"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Berquet G, Prunel P, Verhoest G. et al. The use of a ureteral access sheath does not improve stone-free rate after ureteroscopy for upper urinary tract stones. World J Urol. 2014;32:229\u2013232.","DOI":"10.1007\/s00345-013-1181-5"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Kourambas J, Byrne RR, Preminger GM. Does a ureteral access sheath facilitate ureteroscopy? J Urol. 2001;165:789\u2013793.","DOI":"10.1016\/S0022-5347(05)66527-5"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"L\u2019esperance JO, Ekeruo WO, Scales CD. Jr et al. Effect of ureteral access sheath on stone-free rates in patients undergoing ureteroscopic management of renal calculi. Urology. 2005;66:252\u2013255.","DOI":"10.1016\/j.urology.2005.03.019"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Traxer O, Thomas A. Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. J Urol. 2013;189:580\u2013584.","DOI":"10.1016\/j.juro.2012.08.197"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Rehman J, Monga M, Landman J, et al. Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths. Urology. 2003;61:713\u2013718.","DOI":"10.1016\/S0090-4295(02)02440-8"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"T\u00fcrk C, Pet\u0159\u00edk A, Sarica K et al. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol. 2016 Mar; 69(3):475-82.","DOI":"10.1016\/j.eururo.2015.07.041"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Emad R Rizkala and ManojMonga. Controversies in ureteroscopy: Wire, basket, and sheath. Indian J Urol. 2013 Jul-Sep; 29(3): 244\u2013248. doi: 10.4103\/0970-1591.117287.","DOI":"10.4103\/0970-1591.117287"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Patel SR, McLaren ID, Nakada SY. The ureteroscope as a safety wire for ureteronephroscopy. J Endourol. 2012 Apr; 26(4):351-4.","DOI":"10.1089\/end.2011.0406"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Dickstein RJ, Kreshover JE, Babayan RK, Wang DS. Is a safety wire necessary during routine flexible ureteroscopy? J Endourol. 2010 Oct; 24(10):1589-92.","DOI":"10.1089\/end.2010.0145"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Johnson GB, Portela D, Grasso M. Is a safety wire necessary during routine flexible ureteroscopy? J Endourol. 2006 Aug; 20(8):552-5.","DOI":"10.1089\/end.2006.20.552"}],"container-title":["Journal of Medicine and Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/medandlife.org\/wp-content\/uploads\/JMedLife-14-481.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T07:46:00Z","timestamp":1634283960000},"score":1,"resource":{"primary":{"URL":"https:\/\/medandlife.org\/wp-content\/uploads\/JMedLife-14-481.pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":13,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["JMedLife-14-481"],"URL":"https:\/\/doi.org\/10.25122\/jml-2021-0217","relation":{},"ISSN":["1844-122X","1844-3117"],"issn-type":[{"value":"1844-122X","type":"print"},{"value":"1844-3117","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8]]}}}