The role of suction devices in enhancing outcomes of retrograde intrarenal surgery: a narrative review by the YAU urolithiasis and section of EAU endourology

Purpose of review To provide a comprehensive overview of existing literature on suction-assisted ureteroscopy, evaluating its effectiveness and associated complications. Recent findings A literature review was conducted in December 2024 using the MEDLINE, EMBASE and Scopus databases by two independent authors. To structure and address the clinical question, “Do suction devices improve outcomes in RIRS?”, we employed the PICOS (Patient, Intervention, Comparison, Outcome, Study Type) model. Exclusion criteria included case reports, studies involving suction techniques outside the context of endocorporeal laser lithotripsy (ELL), non-English language articles and articles or clinical trials with fewer than 15 patients. Summary Among the 36 included studies, 28 studies focused on SUAS, of which seven specifically investigated SUAS with pressure measurement, three studies examined DISS, three studies evaluated SURE and two comparative studies analyzed different suction techniques. The presented results show that advancements in suction technology seem very promising and likely to shift endourological practice.