• Jieping Hu, Yue Yu, Wei Liu, Jialei Zhong, Xiaochen Zhou, and Haibo Xi.
• Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
• Int. J. Clin. Pract. 2022 Jan 1; 2022: 33432443343244.

PurposeUreteral access sheaths (UAS) are widely used in retrograde intrarenal surgery (RIRS), and this study aimed to develop a model for predicting the success of UAS placement based on computed tomography.MethodsWe analyzed the clinical data of 847 patients who received ureteroscopy. Data on patient and stone characteristics and several computed tomography (CT)-based measurements were collected. A nomogram predicting the success of UAS placement was developed and validated using R software.ResultsTwo hundred and forty-seven patients were identified. Twenty-five patients (10.1%) failed to pass through the UAS. A model with three factors including the short diameter of ureteral calculi, the short diameter of hydronephrosis, and the diameter of the narrowest part of the renal parenchyma was to be strongly practical and had a high area under the curve on internal validation (80.3%). Using a threshold cutoff of 92%, the sensitivity and specificity for predicting UAS placement were 0.35 and 0.92, respectively.ConclusionOur study provides a nomogram for predicting the success of UAS placement, and this model could help discriminate patients who are likely to suffer from failed UAS insertion; preoperative ureteral stenting is recommended according to the prediction.Copyright © 2022 Jieping Hu et al.

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