Flexible suction ureteral access sheaths vs. sheathless RIRS for renal and proximal ureteral stones: a comparative study

FANS-assisted RIRS demonstrated superior immediate stone clearance compared to sheathless RIRS, which may be particularly advantageous for managing complex or infected stones, where complete initial clearance is clinically paramount. In addition, the significantly shorter stenting duration with FANS offers distinct benefits for stent-intolerant patients. While both techniques achieved similar 1-month stone-free rates, these advantages position FANS as a valuable option for selected patients based on stone characteristics and individual clinical priorities. Further studies should explore long-term outcomes and cost-effectiveness.