Efficacy and Safety of Tip-Flexible Suctioning Ureteral Access in Renal Stone Treatment

BACKGROUND We compared the efficacy and safety of a novel flexible-tip suctioning ureteral access sheath (NFTS-UAS) with flexible ureteroscopy (FURS) versus percutaneous nephrolithotomy (PCNL) for treating unilateral renal calculi (2-3.5 cm). MATERIAL AND METHODS This retrospective study included 337 patients (167 NFTS-UAS, 170 PCNL) treated at Huzhou Normal College's First Affiliated Hospital (March 2021-January 2024). Group 1 underwent FURS with NFTS-UAS, utilizing a flexible-tip sheath connected to a suction device for improved fragment clearance. Group 2 underwent standard PCNL. Outcomes included duration of surgery, stone-free rate (SFR), hospital stay, antibiotic use, and complications. RESULTS The NFTS-UAS group had shorter surgery times (80.02±29.44 vs 98.95±28.82 minutes; P<0.05) and hospital stays (45.62±30.59 vs 173.0±75.46 hours; P<0.05). Preoperative antibiotic use and postoperative infectious complications (eg, elevated neutrophils) were lower in the NFTS-UAS group. While NFTS-UAS had a lower day 1 SFR (68.26% vs 83.53%; P<0.05), SFRs had equalized by day 30 (85.0% vs 89.0%; P=0.21). No intraoperative complications occurred in either group. CONCLUSIONS NFTS-UAS with FURS is a viable alternative to PCNL for 2-3.5 cm renal stones, offering comparable 30-day SFRs, faster recovery, and reduced hospitalization. Further prospective studies are warranted to validate long-term outcomes.