title: Early ureteral catheter removal after ureteroscopic lithotripsy using ureteral access sheath.
abstract: A ureteral access sheath (UAS) can facilitate ureteroscopy (URS) and the retrieval of stone fragments while reducing the intrarenal pressure, thereby improving irrigate flow and decreasing the length of an operation. Ureteral stenting after URS is unnecessary for uncomplicated cases. This study examined the early removal of postoperative ureteral catheterization after URS for cases that used a UAS. A total of 93 patients underwent ureteroscopic lithotripsy with the early removal of ureteral catheterization. Sixty-three of these patients underwent surgery with the use of UAS and were analyzed in this study. Postoperative hydronephrosis was assessed using ultrasonography 3 days after the operation and computed tomography 2 weeks after operation in all patients. Post-operative complications including fever, prolonged hospitalization, frequent usage of painkillers and the re-insertion of ureteral stent were also investigated. Hydronephrosis was detected 3 days after the operation in 34 patients (54.0 %) and 2 weeks after the operation in four patients (6.3 %). No hydronephrosis was detected after a 2-month follow-up in these four patients. The mean operation time in the hydronephrosis group was significantly higher at 58.9 min than in the non-hydronephrosis group at 45.5 min (p < 0.05). Post-operative fever (38 °C) was seen in one case, the frequent usage of painkillers was seen in four cases, a prolonged hospital stay was seen in five cases, and ureteral stent re-insertion was observed in one case. The early removal of ureteral catheterization can be safely performed for the patients that undergo URS with UAS.
authors.affiliation: Department of Urology, Ohguchi Higashi General Hospital, 2-19-1, Irie, Kanagawa-ku, Yokohama City, Kanagawa, Japan. takashi_tk2001@yahoo.co.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawahara
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ito
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Terao
authors.forename: Manabu
authors.initials: M
authors.lastname: Kakizoe
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Kato
authors.forename: Hiroji
authors.initials: H
authors.lastname: Uemura
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kubota
authors.forename: Junichi
authors.initials: J
authors.lastname: Matsuzaki
mesh_terms: D000328:Adult; D000368:Aged; D020878:Device Removal; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018666:Ureteroscopy / Q000379:methods*; D062885:Urinary Catheters