Management of a large mid-ureteral stone using flexible vacuum-assisted ureteral access sheath and holmium laser lithotripsy: a case report
Year: 2026
Type: article
Study design: Case Report
Abstract: Backgrounds: Management of large mid-ureteral stones remains challenging due to anatomical constraints and the limitations of traditional techniques. Recent advances in flexible ureteroscopy and vacuum-assisted access sheaths offer new strategies for safe and effective stone removal. Case Description: We report the case of a 60-year-old male who presented with right-sided colicky flank pain. Non-contrast computed tomography revealed a 62 × 14 mm high-density stone located in the right mid-ureter, with associated hydronephrosis. Laboratory tests were largely unremarkable. The patient underwent successful holmium:YAG laser lithotripsy using a disposable digital flexible ureteroscope inserted through a deflectable vacuum-assisted ureteral access sheath. Continuous low-pressure suction minimized stone migration and maintained a clear surgical field. The procedure was completed in a single session without complications. Postoperative KUB radiography at one month confirmed complete stone clearance and normal urinary drainage. Conclusions: This case illustrates the short-term feasibility and clinical benefit of vacuum-assisted flexible ureteroscopy for treating large mid-ureteral stones. It may serve as a minimally invasive, efficient, and safe alternative to traditional surgical approaches, broad claims regarding its generalized safety require further validation with objective intraoperative measurements in larger cohorts.
Source: Canadian Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7170844147
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