• Mehmet Uslu, Ümit Yildirim, Mehmet Ezer, Ömer Erkam Arslan, Hikmet Yaşar, and Kemal Sarica.
• Kafkas University, Medical School, Department of Urology - Kars, Turkey.
• Rev Assoc Med Bras (1992). 2024 Jan 1; 70 (12): e20241033e20241033.

ObjectiveThe aim of this study was to compare the success and complication rates of retrograde intrarenal surgery for lower calyceal renal stones performed with novel tip-bendable suction ureteral access sheaths and standard ureteral access sheaths.MethodsBetween March 2023 and March 2024, a total of 88 patients underwent retrograde intrarenal surgery for lower renal calyceal stones smaller than 20 mm. Based on the access sheath used, patients were divided into two groups: Group 1 (n=43) included patients treated with novel tip-bendable suction ureteral access sheaths and Group 2 (n=45) included patients treated with standard ureteral access sheaths. The pre- and postoperative data of the two groups were compared. Complications were assessed by using the Modified Clavine Dindo system, and stone-free rate was assessed after 4 weeks by using non-contrast computed tomography.ResultsThere was no significant difference between the groups regarding demographic data or preoperative laboratory results, and the median stone size was comparable in both groups. The stone-free rate did not show any significant difference between the two groups. However, the median residual stone size was substantially higher in the standard ureteral access sheaths group [4.25- (3.75-5) vs. 6- (5-7), p=0.01] and the surgical duration was less in the novel tip-bendable suction ureteral access sheaths group (p=0.032).ConclusionOur current findings demonstrate that the use of a new tip-bendable suction-assisted access sheath during retrograde intrarenal surgery in the management of lower calyceal stones less than 2 cm may shorten the operative duration, limit the rate of complications, and end up with smaller residual stone fragments when compared with the use of standard ureteral access sheath.

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