title: Rigid Ureteroscope Aided Insertion of Ureteral Access Sheath in Retrograde Intrarenal Surgery.
abstract: To compare the outcomes of the ureteral access sheath (UAS) placement techniques in patients undergoing retrograde intrarenal surgery.
  
  
  
  The patients were divided into two groups with respect to placement method of UAS. UAS was placed with the classical method, through the guidewire, in the first group of the patients (group I). The outer sheath of UAS was worn on the semirigid endoscope and placed into the ureter under direct vision in the second group (group II). The number of patients was the same in two groups (n = 42).
  
  
  
  Overall, 70 of 84 (83.3%) patients were stone free after the initial treatment. The success rates were comparable between the two groups (80.9% vs 85.7%, P = .859) 1 month after surgery. Fluoroscopy screening time (11.7 ± 5.7 seconds vs 0 second), UAS placement time (245 ± 138.4 seconds vs 40 ± 17.9 seconds; P < .001), and operation time (58.7 ± 17.1 minutes vs 51.2 ± 16.7 minutes; P = .046) were significantly longer in group I when compared to group II. The complication rate was higher in group I when compared to group II (23.8% vs 9.5%), but the difference was not statistically significant (P = .079).
  
  
  
  Introducing UAS into ureter under direct vision while it was precisely worn on ureteroscope makes this step safer, and protects the surgeon and patient from radiation exposure by shortening fluoroscopy and operation times.
authors.affiliation: Department of Urology, Erzurum Training and Research Hospital, Ankara, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Karabulut
authors.affiliation: Department of Urology, Erzurum Training and Research Hospital, Ankara, Turkey.
authors.forename: Ercument
authors.initials: E
authors.lastname: Keskin
authors.affiliation: Department of Urology, Erzurum Training and Research Hospital, Ankara, Turkey.
authors.forename: Fevzi
authors.initials: F
authors.lastname: Bedir
authors.affiliation: Department of Urology, Erzurum Training and Research Hospital, Ankara, Turkey.
authors.forename: Fatih Kursat
authors.initials: FK
authors.lastname: Yilmazel
authors.affiliation: Department of Urology, School of Medicine, University of Ataturk, Erzurum, Turkey.
authors.forename: Tevfik
authors.initials: T
authors.lastname: Ziypak
authors.affiliation: Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Omer Gokhan
authors.initials: OG
authors.lastname: Doluoglu
authors.affiliation: Department of Urology, School of Medicine, University of Ondokuz Mayis, Samsun, Turkey. Electronic address: drberkan79@gmail.com.
authors.forename: Berkan
authors.initials: B
authors.lastname: Resorlu
authors.affiliation: Department of Urology, School of Medicine, University of Ondokuz Mayis, Samsun, Turkey.
authors.forename: Cankon
authors.initials: C
authors.lastname: Germiyanoglu
mesh_terms: D000328:Adult; D004867:Equipment Design; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D020709:Ureteroscopes; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods