Comparison of percutaneous nephrolithotomy and flexible ureterorenoscopy in the treatment of single upper ureteral calculi larger than 10 mm:a retrospective study

Abstract

Purpose: To compare the efficacy and safety of micropercutaneous nephrolithotomy (MPCNL) and flexible ureteroscopy (FURS) in the treatment of single upper ureteral calculi larger than 10 mm. Methods: This is a retrospective study that incorporates medical record review with an outcomes management database.163 patients who underwent MPCNL and 137 patients who underwent FURS were identified from January 2017 to December 2021. Demographic data,operation time,hospitalization time,stone free rate and complication rate were collected and analyzed. Results: Preoperative general data of sex, age, BMI,serum creatinine, time of stone existence,stone hardness,stone diameter preoperative hydronephrosis and preoperative infection of the MPCNL group have no statistically significant difference with that of the FURS group.All of the MPCNL or FURS surgeries in two groups were successfully completed, with no one returned to opening or other surgery.Patients treated by MPCNL had significantly shorter operation time (49.6 vs 72.4 minutes;P＜0.001) but longer hospitalization time (9.1 vs 3.9days;P＜0.001) than those treated by FURS.Stone free rate in the MPCNL group was better than that of the FURS group(90.8% vs 71.5%;P＜0.001). There was no statistically significant difference in complication rate between two groups(13.5% vs 15.3%;P＝0.741). Conclusion: Both MPCNL and FURS are effective and safe surgical options for patients with single upper ureteral calculi larger than 10 mm. FURS had shorter hospitalization time than MPCNL,but with a relatively lower stone free rate and longer operation time.There was no significant differences between two groups in complication rate. Trial registration: No.