Comparison between Retrograde Flexible Ureteroscopy and Percutaneous Nephrolithotomy for the Treatment of Renal Stones of 2–4 cm
<i>Background and objectives:</i> Renal stones are widespread, with a lifetime prevalence of 10% in adults. Flexible ureteroscopy enables urologists to treat lower calyx stones or even complex renal stones through the natural orifice and achieve an acceptable stone-free rate. Hence, we a...
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MDPI AG
2023-01-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/1/124 |
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| author | Cozma Cosmin Dragos Adrian Georgescu Petrisor Geavlete Razvan-Ionut Popescu Bogdan Geavlete |
| author_facet | Cozma Cosmin Dragos Adrian Georgescu Petrisor Geavlete Razvan-Ionut Popescu Bogdan Geavlete |
| author_sort | Cozma Cosmin |
| collection | DOAJ |
| description | <i>Background and objectives:</i> Renal stones are widespread, with a lifetime prevalence of 10% in adults. Flexible ureteroscopy enables urologists to treat lower calyx stones or even complex renal stones through the natural orifice and achieve an acceptable stone-free rate. Hence, we analyzed the effectiveness and safety of FURS versus PCNL in treating renal stones between 20 and 40 mm in diameter. <i>Materials and methods:</i> We retrospectively analyzed 250 consecutive patients with large renal solitary stones (stone burden between 2 and 4 cm) from 1 January 2019 to 31 December 2020. The patients were divided into two groups: group 1 (125 patients), in which the patients were treated by a retrograde flexible ureteroscopic approach, and group 2 (125 patients), in which we used percutaneous nephrolithotomy. Stone characteristics and anatomical data were observed based on the computed tomography (CT) and/or KUB (Kidney-ureter-Bladder) radiography imaging archive. <i>Results:</i> The mean stone burden was 26.38 ± 4.453 mm in group 1 and 29.44 ± 4.817 mm in group 2. The stone-free rate after the first ureteroscopy was higher for the PNL(percutaneous nephrolithotomy) group (90.4%) than the F-URS group (68%). After two sessions of ureteroscopy, the SFR was 88.8% in the first group, and after three procedures, the SFR rose to 95.2%. The overall complication rate was higher in group 1 than in group 2 (18.4% vs. 16.8%), but without statistical relevance (<i>p</i> > 0.5). Furthermore, we encountered more grade III and IV complications in the PNL group (8.8% vs. 4.8%, <i>p</i> < 0.05). <i>Conclusion:</i> Flexible ureteroscopy proves to be efficient in treating renal stones over 2 cm. However, the patients must be informed that more than one procedure might be necessary to overcome the entire stone burden. |
| first_indexed | 2024-03-09T11:44:50Z |
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| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T11:44:50Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj.art-c5bfd44aaed14d85bfbc99460f60d4842023-11-30T23:24:41ZengMDPI AGMedicina1010-660X1648-91442023-01-0159112410.3390/medicina59010124Comparison between Retrograde Flexible Ureteroscopy and Percutaneous Nephrolithotomy for the Treatment of Renal Stones of 2–4 cmCozma Cosmin0Dragos Adrian Georgescu1Petrisor Geavlete2Razvan-Ionut Popescu3Bogdan Geavlete4Department of Urology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Urology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Urology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Urology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Urology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania<i>Background and objectives:</i> Renal stones are widespread, with a lifetime prevalence of 10% in adults. Flexible ureteroscopy enables urologists to treat lower calyx stones or even complex renal stones through the natural orifice and achieve an acceptable stone-free rate. Hence, we analyzed the effectiveness and safety of FURS versus PCNL in treating renal stones between 20 and 40 mm in diameter. <i>Materials and methods:</i> We retrospectively analyzed 250 consecutive patients with large renal solitary stones (stone burden between 2 and 4 cm) from 1 January 2019 to 31 December 2020. The patients were divided into two groups: group 1 (125 patients), in which the patients were treated by a retrograde flexible ureteroscopic approach, and group 2 (125 patients), in which we used percutaneous nephrolithotomy. Stone characteristics and anatomical data were observed based on the computed tomography (CT) and/or KUB (Kidney-ureter-Bladder) radiography imaging archive. <i>Results:</i> The mean stone burden was 26.38 ± 4.453 mm in group 1 and 29.44 ± 4.817 mm in group 2. The stone-free rate after the first ureteroscopy was higher for the PNL(percutaneous nephrolithotomy) group (90.4%) than the F-URS group (68%). After two sessions of ureteroscopy, the SFR was 88.8% in the first group, and after three procedures, the SFR rose to 95.2%. The overall complication rate was higher in group 1 than in group 2 (18.4% vs. 16.8%), but without statistical relevance (<i>p</i> > 0.5). Furthermore, we encountered more grade III and IV complications in the PNL group (8.8% vs. 4.8%, <i>p</i> < 0.05). <i>Conclusion:</i> Flexible ureteroscopy proves to be efficient in treating renal stones over 2 cm. However, the patients must be informed that more than one procedure might be necessary to overcome the entire stone burden.https://www.mdpi.com/1648-9144/59/1/124flexible ureteroscopypercutaneous nephrolithitomyrenal lithiasis |
| spellingShingle | Cozma Cosmin Dragos Adrian Georgescu Petrisor Geavlete Razvan-Ionut Popescu Bogdan Geavlete Comparison between Retrograde Flexible Ureteroscopy and Percutaneous Nephrolithotomy for the Treatment of Renal Stones of 2–4 cm Medicina flexible ureteroscopy percutaneous nephrolithitomy renal lithiasis |
| title | Comparison between Retrograde Flexible Ureteroscopy and Percutaneous Nephrolithotomy for the Treatment of Renal Stones of 2–4 cm |
| title_full | Comparison between Retrograde Flexible Ureteroscopy and Percutaneous Nephrolithotomy for the Treatment of Renal Stones of 2–4 cm |
| title_fullStr | Comparison between Retrograde Flexible Ureteroscopy and Percutaneous Nephrolithotomy for the Treatment of Renal Stones of 2–4 cm |
| title_full_unstemmed | Comparison between Retrograde Flexible Ureteroscopy and Percutaneous Nephrolithotomy for the Treatment of Renal Stones of 2–4 cm |
| title_short | Comparison between Retrograde Flexible Ureteroscopy and Percutaneous Nephrolithotomy for the Treatment of Renal Stones of 2–4 cm |
| title_sort | comparison between retrograde flexible ureteroscopy and percutaneous nephrolithotomy for the treatment of renal stones of 2 4 cm |
| topic | flexible ureteroscopy percutaneous nephrolithitomy renal lithiasis |
| url | https://www.mdpi.com/1648-9144/59/1/124 |
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