Suction-Assisted Ureteroscopy Linked to Better Outcomes in Kidney Stone Patients with Preoperative Infections
A retrospective study published in Nature Health Sciences suggests that using a flexible negative-pressure suction ureteral access sheath during ureteroscopy improves stone-free rates and lowers complication risks in patients with initially positive urine cultures.
Key points
- Suction sheath use linked to 89.0% single-session stone-free rate
- Overall complication rates dropped to 15.0% from 26.6%
- Study examined 173 matched pairs with positive initial cultures
Researchers at the Chuzhou Hospital Affiliated to Anhui Medical University evaluated adults treated for renal stones between August 2022 and August 2025 who presented with initially positive preoperative urine cultures. After implementing a flexible negative-pressure suction ureteral access sheath in January 2024, the team conducted a retrospective analysis using 1:1 propensity-score matching, resulting in 173 patient pairs. Prior to surgery, all participants received susceptibility-guided antimicrobials until achieving a negative repeat culture.
According to the findings, single-session stone-free status—defined as residual fragments of three millimeters or smaller at one month—occurred significantly more often in the suction group compared to the control group (89.0% versus 75.7%). Complete clearance rates also favored the suction technique at 74.0% versus 59.0%. Furthermore, patients operated on with the suction sheath experienced lower mean and peak intrarenal pressures and reduced high-pressure exposure during the procedure.
Overall complications dropped from 26.6% in the standard group to 15.0% in the suction cohort. While the study points to promising associations, including a reduction in non-septic fever and lower culture positivity odds, the authors emphasize that this was an observational, retrospective study. Therefore, causal effects cannot be definitively established without confirmation from larger multicenter randomized trials. Always talk to a doctor for personal medical decisions and specialized care.
Source Nature Health Sciences — nature.com/articles/s41598-026-75798-1 ↗
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