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Funding Information Abbreviations Used CI confidence interval ED emergency department MUSIC Michigan Urological Survey Improvement Collaborative OR odds ratio SFR stone-free rate UAS ureteral access sheath URS ureteroscopy References 1 Scales Jr CD, Smith AC, Hanley JM, Saigal CS, Urologic Diseases in America Project. Nephrolithiasis affects ~10% of people in the United States.[1] Because those who require surgery most commonly undergo ureteroscopy (URS), the way that this surgery is performed has the potential to impact a large number of patients.[2] Technologic advances such as flexible endoscopes have made URS safer, faster, and more effective.[3] However, with new technology comes a need to identify its most appropriate application. Interestingly, sheath use was also found to independently predict discharge with an opioid prescription.[25] The strongest case for avoiding a sheath may thus be in those patients whose anatomy and stone burden could have allowed for stentless URS. [Extracted from the article]