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Intrarenal Surgery for Kidney Stones and Other Kidney Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 20 February 2026 | Viewed by 100

Special Issue Editor


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Guest Editor
Department of Urology, “St. John” Emergency Clinical Hospital, 042122 Bucharest, Romania
Interests: kidney stones; urolithiasis; flexible ureteroscopy; percutaneous nephrolithotomy; metaphylaxis; laser; lithotripsy
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Special Issue Information

Dear Colleagues,

Intrarenal surgery is an evolving landscape that encompasses both established and novel approaches to the management of kidney stones and other renal pathologies. Recent advances in endourology have included novel lasers; thinner flexible ureteroscopes, most of which are single-use; miniaturized percutaneous nephrolithotomy; and novel accessory instruments such as flexible and navigable access sheaths or automated platforms that incorporate artificial intelligence to regulate irrigation and suction for enhanced visibility and safety. All of these developments have significantly enhanced surgical efficacy, reduced morbidity, and expanded the indications for minimally invasive interventions. Beyond lithiasis, intrarenal surgery is increasingly applied to the management of other pathologies such as urothelial tumors or congenital abnormalities. The integration of these new devices and techniques is transforming standards and the outcome of procedures. This Special Issue welcomes the submission of original research and clinical perspectives on operative techniques, outcome metrics, complication management, and future innovations in intrarenal surgery.

Dr. Razvan Multescu
Guest Editor

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Keywords

  • intrarenal surgery
  • flexible ureteroscopy
  • percutaneous nephrolithotomy (PCNL)
  • Mini-PCNL
  • thulium laser
  • ureteral access sheaths
  • flexible and navigable suction (FANS)
  • upper urinary tract urothelial tumors

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Published Papers (1 paper)

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Research

11 pages, 909 KB  
Article
Optimizing the Scope–Sheath Compatibility in RIRS: Matching of Reusable and Single-Use Flexible Ureteroscopes with FANS
by Petrisor Geavlete, Razvan Multescu, Cosmin Ene, Bogdan Buzescu and Bogdan Geavlete
J. Clin. Med. 2025, 14(20), 7215; https://doi.org/10.3390/jcm14207215 (registering DOI) - 13 Oct 2025
Abstract
Background/Objectives: Adoption of single-use ureteroscopes (SU) and flexible and navigable suction ureteral access sheaths (FANS) have improved flexible ureteroscopy (fURS) efficiency and safety. However, the impact of scope–sheath pairing is less studied. This study aims to compare four scope–sheath configurations using reusable [...] Read more.
Background/Objectives: Adoption of single-use ureteroscopes (SU) and flexible and navigable suction ureteral access sheaths (FANS) have improved flexible ureteroscopy (fURS) efficiency and safety. However, the impact of scope–sheath pairing is less studied. This study aims to compare four scope–sheath configurations using reusable ureteroscopes (RU) and SU with either 11/13Fr or 12/14Fr FANS. Methods: We retrospectively evaluated 184 patients undergoing fURS for kidney solitary stones of 10–25 mm. Patients were manually matched across four groups: RU-11/13FANS, RU-12/14FANS, SU-11/13FANS, and SU-12/14FANS (46 patients in each). The endpoints were 30-day stone-free rate (SFR), operative time, surgeon-reported visibility (image clarity and procedural continuity) and postoperative complications. Results: Operative time was significantly shorter in single-use scope groups (p < 0.001). Visibility scores were highest in SU-12/14FANS and lowest in RU-11/13FANS across all subdomains. SFR was higher in SU groups. SU-11/13FANS had a significantly higher SFR than RU-12/14FANS (p = 0.027). In the reusable group, the use of 12/14Fr FANS was associated with a lower SFR compared to the 11/13Fr configuration. Complication rates were low (8.2% overall) and comparable among groups. Conclusions: Pairing SU with 12/14Fr FANS provided optimal visibility and good stone clearance without increasing complications. In contrast, RU paired with 12/14Fr FANS showed slightly reduced efficacy, possibly due to impaired maneuverability. The scope–sheath interaction influenced outcomes differently across scope types, underlining the importance of their matching in fURS. Full article
(This article belongs to the Special Issue Intrarenal Surgery for Kidney Stones and Other Kidney Diseases)
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