WITHDRAWN: Flexible Uretero-Renoscopy Versus Mini-Percutaneous Nephrolithotomy for Treatment of Renal Stones 2 Cm or Less; A Randomised, Comparative Study

Abstract

Purpose: To compare the outcomes of treatment of renal stones of 2 cm or less with either fURS or mPCNL.Methods: This was a prospective, randomized, comparative study conducted between January 2019 and July 2021 at three tertiary care Urology centers. Inclusion criteria were adult patients with renal stone(s) ≤ 2cm with inappropriateness or failure of extracorporeal shock-wave lithotripsy. The two treatment groups were mPCNL and fURS. Mini-percutaneous nephrolithotomy was done in the prone position under fluoroscopic guidance using a 12-Fr., rigid Nephroscope with the track dilated up to 18 Fr. The study assessed two primary outcomes: (1) initial success rate, which meant absence of CSRF (> 2mm) at the level of KUB and ultrasound on the 1st post-operative day; (2) complications, which were reported according to the Modified Clavien-Dindo classification system. Secondary outcomes included final success rate, which meant absence of CSRF at the level of NCCT on the 90th post-operative day; operative time; auxiliary procedure and blood transfusion rates; haemoglobin drop; and hospital stay.Results: One hundred eighteen procedures were analysed (59 in each group). Initial success rate of mPCNL (93%) was significantly higher than fURS (70%). Complications occurred more frequently with mPCNL (44.1% versus 18.6%, respectively). Final success rate, operative time and hospital stay were comparable between the two groups.Conclusion: Mini-percutaneous nephrolithotomy is more effective than fURS as a rapid, single-step treatment for renal stones due to its higher first-day success rate and lower auxiliary procedure rate. However, it results in significantly higher morbidity than fURS.