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The following is a summary of “Assessment of Outcomes & Anatomical Changes in the Upper Urinary Tract following Flexible Ureteroscopy with a Flexible and Navigable Suction Ureteral Access Sheath (FANS): 3-Month Results from a Multicenter Study,” published in the January 2025 issue of Urology by Fong et al. 

Researchers conducted a retrospective study to evaluate the long-term outcomes of flexible and navigable suction ureteral access sheaths (FANS) in flexible ureteroscopy (FURS). The results showed low 3-month adverse outcomes, high success rates, and minimal reintervention, confirming FANS’ safety and effectiveness. 

They conducted a prospective study of patients with normal renal anatomy who underwent FURS with FANS for renal stones from April 2023 to August 2024 at 16 centers. They analyzed the 30-day stone-free rate using non-contrast CT and assessed delayed complications at 3 months with a contrasted CT urogram. 

The results showed that 310 patients were analyzed with a median age of 51 and stone volume of 1,584 mm³. Disposable scopes were used in 58.1%, and Thulium fiber laser was the most common energy (56.1%). The median laser time was 14 minutes, the ureteroscopy time was 30 minutes, and the total operation time was 45 minutes. The ureteric injury occurred in 11 patients (3.5%), with 10 classified as Traxer-Thomas Grade 1. On the 30-day NCCT, 63.5% had zero residual fragments, and 95.1% were stone-free. The 30-day reintervention rate was 4.2% (13 cases). At 3 months, CT urogram showed ureteric stenosis in 1 patient (0.3%), managed by dilatation and stenting, with no other anatomical anomalies. 

Investigators concluded that the low 3-month adverse outcomes and high immediate stone-free rate confirmed FANS’ safety and effectiveness. 

Source: goldjournal.net/article/S0090-4295(25)00040-8/abstract