الفهرس 
Introduction and RationaleOnly 14 pages are availabe for public view
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Abstract
Urinary stone disease remains a significant health problem in the adult population, with the incidence of urolithiasis estimated to be as high as 12% in the developed countries but the incidence is higher in the developing countries. (Finlayson, 1999)
The ureteral access sheath can induce transient ureteral ischemia and promote an acute inflammatory response, but it also prevents potentially harmful elevations in intrarenal pressure. Unequivocal data are not yet available to suggest that ureteral access sheath use during ureteroscopy protects or harms the upper urinary tract. A large prospective study is needed to unequivocally determine if ureteral access sheath use is superior in terms of stone-free rates. Cost studies reported to favor ureteral access sheath use, although a formal cost-effectiveness analysis has not been performed. Further study is needed before routine use of the ureteral access sheath can be recommended. (Stern JM, et al., 2007)
However, no formal evaluations have been performed to assess the routine use of ureteral access sheaths during semi-rigid ureteroscopy. ( Kourmbas, 2011)
This study was done in the Urology Department at the Faculty of Medicine, Suez Canal University between 2012 and 2015. It was conducted to 36 patients undergoing retrograde ureteroscopy for the lower and middle ureteric stones by a semi-rigid ureteroscopy divided into two equal groups according to the using and the non-using of the of ureteral access sheath. group A (18 patients) without the access sheath and group B (18 patients) with the access sheath during ureteroscopy.
The aim of this study is to evaluate the efficacy of ureteral access sheath on stone free rate and to study the values of ureteral access sheath in improving post-operative symptoms, decreasing complications rate and if it is saving time in ureteroscopy procedures.