Flexible mini-percutaneous nephrolithotomy versus retrograde intra-renal surgery in the management of renal stones: a randomized controlled trial.

Ahmed Higazy, M Kandil, Ahmed Elshafei, M Esmat, A M Tawfeek

Abstract readRandomized Controlled TrialComparative Study

In one paragraph

Trial report in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it

0cells of the map it votes in

5citing papers in PubMed, 2 pooled it

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

Retrograde intrarenal surgery versus miniaturized percutaneous nephrolithotomy for renal calculi: a grade-assessed meta-analysis of randomized controlled trials with trial sequential analysis.World journal of urology · 2026
Pooled it
Hybrid endoscopic-robotic approaches for complex upper urinary tract disorders: a systematic review and single-arm meta-analysis.Journal of robotic surgery · 2025
Pooled it
Flexible ureteroscopy with a flexible and navigable suction ureteral access sheath versus mini-percutaneous nephrolithotomy for renal stones larger than 2 cm in patients with a solitary kidney: a propensity score-matched and win ratio analysis.World journal of urology · 2026
Article
Comparison of vacuum-assisted flexible ureteroscopy and percutaneous nephrolithotomy for 2-3 cm upper tract stones: a real-world cohort study.Frontiers in surgery · 2026
Article
Identification and validation of glycosaminoglycan metabolism-associated immune biomarkers in patients with ischemic stroke based on weighted gene co-expression network analysis and machine learning.Frontiers in neurology
Article

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ahmed HigazyUrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Ahmedmaherhigazy@gmail.com.ORCID http://orcid.org/0000-0002-9679-4241

M KandilUrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Ahmed ElshafeiUrology Department, Faculty of Medicine, Modern University for Technology and Information, Cairo, Egypt.ORCID http://orcid.org/0000-0001-6140-6379

M EsmatUrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

A M TawfeekUrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.ORCID http://orcid.org/0000-0003-2534-2261

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the safety, efficacy, and cost-effectiveness of flexible mini-percutaneous nephrolithotomy (F-mPCNL) in managing nephrolithiasis compared to retrograde intrarenal surgery (RIRS).

methods130 adult patients with renal stones (1.5-3 cm) were randomized to F-mPCNL or RIRS. The stone-free rate (SFR) was our primary outcome. Secondary outcomes were the operative time, fluoroscopy time, DJ stent insertion rate, auxiliary procedure needed, hospital stay, complications rate, total cost, and quality of life for both procedures.

resultsout of 130 patients in our study, 125 were evaluated and completed the follow-up period. Preoperative data was similar in both groups including stone characteristics. F-mPCNL showed a better SFR of 95.1% compared to 77.8% in the RIRS group (p-value˂0.001), this was associated with less need for additional procedures. F-mPCNL was associated with a shorter operation time of 47.60 ± 14.54 min compared to 59.30 ± 20.10 min in the RIRS group (p-value˂0.001). F-mPCNL showed less radiational exposure and less need for DJ stent insertion than RIRS. The overall complication rate was comparable in both groups, postoperative pain, need for extra doses of analgesics, and hospital stay were higher in the F-mPCNL group. In our study, F-mPCNL was shown to be more cost-effective than RIRS.

conclusionF-mPCNL showed a superior SFR in treating renal stones compared to RIRS in a single session, with less need for auxiliary procedures, shorter operative time, less radiational exposure, and better quality of life. However, it was associated with slightly more hospital stay and postoperative pain compared to RIRS.

Indexed as

Kidney CalculiNephrolithotomy, PercutaneousAdultAgedCost-Effectiveness AnalysisFemaleHumansLength of StayMaleMiddle AgedOperative TimeTreatment OutcomeCystonephroscopeFlexible mini-percutaneous nephrolithotomyMini-percutaneous nephrolithotomyRetrograde intrarenal surgeryStones

Identifiers

PMID40418257

DOI10.4103/UA.UA_10_20

PMCPMC12106488

What OpenQuestion holds

Textmetadata

LicenceCC BY

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.