UAS Is Not Associated With Lower Infection Risk

Background: Infection is a frequent complication of ureteroscopy (URS). Although ureteral access sheath (UAS) may decrease intrarenal pressure leading to a theoretical reduction in infection risk, clinical evidence supporting this is lacking. Objective: To assess the risk and determinants of post-URS infection with versus without UAS. Design: Multicenter, retrospective observational study. Methods: This study was conducted using the Michigan Urological Surgery Improvement Collaborative (MUSIC) registry. Multivariable logistic regression was used to assess the odds of 30-day infection-related hospitalization after URS with versus without UAS. Results: 6142 patients met study criteria who underwent URS by 233 urologists at 34 practices. UAS was used in 3603 (59%) cases. Wide variation in UAS utilization was noted across practices (4.1% to 99.5%). Rates of infection-related hospitalization were comparable between UAS versus no UAS (2.6% vs 2.3%). Adjusted odds of infection-related hospi more...