ArticleWorld journal of urology2023
PCNL vs RIRS in management of stones in calyceal diverticulum: outcomes from a global multicentre match paired study that reflects real world practice.
Article in World journal of urology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Percutaneous nephrolithotomy versus retrograde intrarenal surgery: a systematic review and meta-analysis of stone-free rates and complication profiles.International urology and nephrology · 2026Pooled it
- Clinical exploration of flexible ureteroscopy combined with holmium laser and intraoperative ultrasound localization for the treatment of stones in non-communicating calyceal diverticula: a single case report.Frontiers in surgery · 2026Article
- In vivo evaluation of the outflow pattern of pediatric nephroscope with various access sheaths.Urolithiasis · 2025Article
- Innersight, a novel software for the formation of preoperative CT-based 3D models for the treatment of lithiasis: does it really help? A pilot study.World journal of urology · 2025Article
- In vivo and in vitro evaluation of the Swiss LithoClastWorld journal of urology · 2025Article
- Renal artery pseudoaneurysm following holmium laser diverticular neck incision for calyceal diverticular stones: a rare case report.Frontiers in surgery · 2025Article
- Harnessing magnetism: evaluation of safety, tolerance and feasibility of magnetic kidney stone retrieval in vivo in porcine models.Urolithiasis · 2024Article
- Evaluation of the learning curve for Thulium fiber laser enucleation of prostate (ThuFLEP): retrospective study of a single-surgeon experience in real-world settings.World journal of urology · 2024Article
Corrections and comments
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Authors and funding
22 authors at 17 institutions in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCalyceal diverticulum (CD) is the outpouching of a calyx into the renal parenchyma, connected by an infundibulum. Often associated with recurrent stones, common surgical options include percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS). We aim to present the real-world practises and outcomes comparing both approaches and the technical choices made. MATERIALS AND
methodsRetrospective data including 313 patients from 11 countries were evaluated. One hundred and twenty-seven underwent mini-PCNL and one hundred and eighty-six underwent RIRS. Patient demographics, perioperative parameters, and outcomes were analysed using either T test or Mann-Whitney U test. Categorical data between groups were analysed using the Chi-squared test. Propensity score matching (PSM) was performed matching for baseline characteristics. Subgroup analyses for anomalous/malrotated kidneys and difficult diverticulum access were performed.
resultsAfter PSM, 123 patients in each arm were included, with similar outcomes for stone-free rate (SFR) and complications (p < 0.001). Hospitalisation was significantly longer in PCNL. Re-intervention rate for residual fragments (any fragment > 4 mm) was similar. RIRS was the preferred re-intervention for both groups. Intraoperative bleeding was significantly higher in PCNL (p < 0.032) but none required transfusion. Two patients with malrotated anatomy in RIRS group required transfusion. Lower pole presented most difficult access for both groups, and SFR was significantly higher in difficult CD accessed by RIRS (p < 0.031). Laser infundibulotomy was preferred for improving diverticular access in both. Fulguration post-intervention was not practised.
conclusionThe crux lies in identification of the opening and safe access. Urologists may consider a step-up personalised approach with a view of endoscopic combined approach where required.
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