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Ureteral access sheath is a sterile endourological access device used during ureteroscopy and retrograde intrarenal procedures to establish a temporary conduit through the ureter into the upper urinary tract. It typically consists of an outer tubular sheath and a tapered dilator that are introduced as a locked assembly over a guidewire. After placement, the dilator is withdrawn while the sheath remains in position, permitting repeated passage of a flexible ureteroscope, laser fibers, retrieval baskets, forceps and other instruments. The sheath wall commonly incorporates polymer layers, a lubricious inner liner, stainless steel coil or braid reinforcement, a hydrophilic outer coating and a radiopaque distal marker. These elements maintain lumen patency, resist kinking, reduce insertion friction and limit direct contact between exchanged instruments and the ureteral mucosa. The annular space between the sheath and ureteroscope also provides an outflow path for irrigation fluid. Suction variants incorporate an aspiration port and pressure control structure for the evacuation of irrigation fluid, blood, stone dust and fragments. Ureteral access sheaths are specified by inner and outer French size, working length, tip configuration, guidewire compatibility and ureteroscope compatibility. The device is removed upon completion of the procedure. A ureteral stent remains within the ureter for temporary drainage after the procedure.
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