Retrograde intrarenal surgery (RIRS) is a minimally invasive procedure for the management of kidney stones. However, achieving a high stone-free rate with minimizing complications remains a challenge. The use of flexible suctioning ureteral access sheath has recently emerged as a tool to enhance endoscopic lithotripsy efficiency. This study aims to evaluate the clinical efficacy of using a flexible suctioning ureteral access sheath(SUAS) in combination with a traditional ureteral access sheath(TUAS) for treating renal stones.

We retrospectively collected clinical data from 238 patients who underwent retrograde intrarenal surgery (RIRS) at Ganzhou People’s Hospital between January 2024 and October 2024. The study included 192 patients who met the inclusion criteria, with 135 in the observation group using flexible suctioning ureteral access sheath and 57 in the control group using traditional ureteral sheath. Preoperative characteristics, intraoperative parameters, and postoperative outcomes were compared. The primary endpoints were stone-free rate and the incidence of postoperative urinary tract infection (UTI) and sepsis.

The baseline characteristics, including stone size and location, were comparable between the two groups. The SUAS group demonstrated a significantly higher stone-free rate at one month (92.3% vs. 75.0%, p<0.05). Moreover, the incidence of postoperative UTI was notably lower in the SUAS group. Operative time was slightly shorter in the SUAS group, though not statistically significant. No major complications related to the use of SUAS were recorded.

The integration of suction access sheath into RIRS significantly improves stone-free rate and reduces postoperative infections. We recommend considering SUAS as a standard adjunct in RIRS for large or multiple stones, particularly in high-risk infection cases.