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Comparison of flexible ureterorenoscopy and micropercutaneous nephrolithotomy in the treatment for moderately size lower-pole stones

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Abstract

Purpose

To present a retrospective comparative clinical study of micropercutaneous nephrolithotomy (microperc) versus flexible ureterorenoscopy (F-URS) in treatment of moderate-size lower-pole stones (LPSs).

Methods

We retrospectively reviewed data on patients with isolated LPSs ≤2 cm in diameter treated with F-URS and/or microperc in two referral centers. Patients were divided into two groups by treatment modality: F-URS (Group 1) and microperc (Group 2). Demographics and perioperative parameters were analyzed.

Results

A total of 127 patients with isolated LPSs were treated via F-URS (Group 1, n = 59) and microperc (Group 2, n = 68). Mean patient age in microperc group was slightly lower than in F-URS group (p = 0.112). We found no statistically significant difference in terms of either the size or number of stones in two groups (p = 0.113 and p = 0.209, respectively). Operative time was shorter in microperc, whereas fluoroscopy time was shorter in F-URS (60.1 ± 26.2 vs. 46.2 ± 24.3 min, p < 0.001; and 28.3 ± 19.1 vs. 108.9 ± 65.2 s, p < 0.001). Mean fall in hemoglobin level was statistically significantly lower in F-URS and hospitalization time was also significantly shorter in F-URS (0.68 ± 0.51 vs. 1.29 ± 0.88 mg/dL, p < 0.001; and 23.0 ± 58.1 vs. 33.8 ± 17.2 h, p < 0.001, respectively). Stone-free rates (SFRs) were 74.5 % (44/59) in Group 1 and 88.2 % (60/68) in Group 2 (p < 0.001).

Conclusions

We found that microperc was safe and efficacious when used to treat moderate-size LPSs and may be considered as an alternative to F-URS, affording a higher SFR. Our study supports the notion that microperc should play an increasing role in treatment of LPSs.

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Conflict of interest

The authors declare that they have no competing interest.

Ethical standard

The study was approved by the local ethics committee and performed in accordance with the Declaration of Helsinki and its amendments. All patients provided written informed consent.

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Authors and Affiliations

  1. Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, 34093, Turkey

    Abdullah Armagan, Muhammed Tosun, Ismail Basibuyuk & Abdulkadir Tepeler

  2. Department of Urology, Faculty of Medicine, Mevlana University, Konya, Turkey

    Tuna Karatag, Ibrahim Buldu & Mustafa Okan Istanbulluoglu

Authors
  1. Abdullah Armagan
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  2. Tuna Karatag
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  3. Ibrahim Buldu
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  4. Muhammed Tosun
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  5. Ismail Basibuyuk
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  6. Mustafa Okan Istanbulluoglu
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  7. Abdulkadir Tepeler
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Correspondence to Abdullah Armagan.

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Armagan, A., Karatag, T., Buldu, I. et al. Comparison of flexible ureterorenoscopy and micropercutaneous nephrolithotomy in the treatment for moderately size lower-pole stones. World J Urol 33, 1827–1831 (2015). https://doi.org/10.1007/s00345-015-1503-x

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  • DOI: https://doi.org/10.1007/s00345-015-1503-x

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