Biopsy of ureteric lesions using a semi-rigid ureteroscope through a ureteric access sheath

Obtaining a tissue diagnosis from a ureteric lesion can be technically difficult. Inadequate tissue sampling with biopsy forceps is common and can delay diagnosis and treatment. The use of backloading biopsy forceps allows larger tissue samples to be obtained when compared with traditional biopsy forceps, which are limited by the diameter of the ureteroscopic working channel. However, backloaded biopsy forceps may reduce vision and hinder safe access of the ureter. The use of an access sheath can allow multiple passes to the ureteric lesion and can improve vision