Efficacy and safety of single-use flexible ureteroscopy combined with a distal articulated suction sheath on impacted ureteric calculi

XU Zhefeng; HONG Xiang; DU Jinglong; YU Liting

doi:10.3969/j.issn.1004-3594.2026.03.008

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Medical Journal of the Chinese People Armed Police Forces ›› 2026, Vol. 37 ›› Issue (3) : 224-229. DOI: 10.3969/j.issn.1004-3594.2026.03.008

ORIGINAL ARTICLES

Efficacy and safety of single-use flexible ureteroscopy combined with a distal articulated suction sheath on impacted ureteric calculi

XU Zhefeng, HONG Xiang, DU Jinglong, YU Liting

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Abstract

Objective To evaluate the efficacy and safety of single-use flexible ureteroscopy (FURS) combined with a distal articulated suction sheath (ASS) in the treatment of impacted ureteral stones in a single-center retrospective cohort. Methods A total of 62 patients with unilateral impacted calculi from December 2023 to December 2024 were enrolled. “Impaction” was defined as stone incarceration≥2 months with focal ureteral-wall thickening≥2 mm. All patients underwent holmium laser lithotripsy via FURS with ASS. The primary outcome was stone-free rate (SFR) on post-operative day 1; secondary outcomes included operative time, perioperative complications (Clavien-Dindo classification), length of stay and 3-6 month follow-up results. One-sample t-test and χ² test were used to compare the data with pooled means from five analogous studies (n=666). Results All 62 cases achieved primary successful sheath placement (success rate 100%). Mean stone diameter was (15.4±4.2) mm and mean CT attenuation (1215±285) HU.SFR on day 1 was 95.2%,peri-operative complications were all Clavien grade Ⅰ-Ⅱ,mean post-operative stay was (2.6±0.9) days. During the 3-6 month follow-up, the SFR was 100% and no ureteral stricture or severe hydronephrosis occurred. Compared with the pooled literature values, the operative time was shortened [(58.6±12.8) min vs. (66.0±14.5) min, t=6.13, P=0.002], the SFR increased (95.2% vs. 88.5%, χ²=6.58, P=0.010), the complication rate was reduced (4.8% vs. 9.4%, χ²=4.31, P=0.038), and all differences were statistically significant. Conclusions Single-use FURS combined with ASS in the treatment of impacted ureteral calculi offers significantly superior outcomes in literature comparisons and be used as the first-line minimally invasive treatment for impacted ureteral stones. However, further multi-center randomized controlled trials are needed to validate the long-term efficacy.

Key words

ureteral calculus / impaction / flexible ureteroscopy / articulated suction sheath / holmium laser

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XU Zhefeng, HONG Xiang, DU Jinglong, YU Liting. Efficacy and safety of single-use flexible ureteroscopy combined with a distal articulated suction sheath on impacted ureteric calculi[J]. Medical Journal of the Chinese People Armed Police Forces. 2026, 37(3): 224-229 https://doi.org/10.3969/j.issn.1004-3594.2026.03.008

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