Presented by: John Lazarus MBChB, FC UROL (SA)
University of Cape Town

Introduction

To describe a novel syphon ureteral access sheath (UAS) intended for use during flexible uretero-renoscopy (fURS). We aimed to report on a pilot study as well as intrarenal pressures (IRP) and irrigant flow volumes compared to traditional UAS.

Materials

Patients undergoing routine fURS for single, <2cm intrarenal nephrolithiasis were identified, and written informed consent was obtained. Irrigation via the fURS was instilled through the novel 11/13 Fr UAS without (a proxy for a traditional UAS) and with the novel syphon box attached. Measured minute irrigant flow volume, steady state and bolus IRP were compared.

Results

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Ten participants (6 males and 4 females) were treated with the syphon UAS. All procedures were completed safely without intra-operative complications.

The mean baseline IRP with and without the syphon was 18 vs 29 mmHG (p<0.001, SD 4.0 vs 4.8).

The mean minute irrigant flow volume with and without the syphon was 31 vs 21 ml (p<0.001, SD 6.4 vs 3.3).

The mean peak IRP following a 10 ml bolus with and without the syphon was 71 vs 104 mmHg (p=0.03, SD 74 vs 59).

Conclusion

The described novel UAS is different from traditional devices by incorporating a syphon mechanism. This pilot trial demonstrates that the novel syphon UAS may hold clinical potential to reduce IRP and increase irrigant flow compared to traditional UAS. Firm conclusions about efficacy and safety require assessment of the device in a larger clinical trial.

Funding

Wismed, Durban, South Africa provided funding for the trial.

Lead Authors

Siyasanga Yekani, MD
University of Cape Town

Co-Authors

Melanie de Bruyn, BSc
University of Cape Town

Lisa Kaestner, PhD
University of Cape Town