ArticleWorld journal of urology2025
Intelligent pressure-controlled ureteral access sheath combined with flexible ureteroscopy versus flexible ureteroscopy and percutaneous nephrolithotomy for renal stones less than 3 cm in diameter: a comparative efficacy study.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo compare the efficacy and postoperative outcomes of three surgical approaches for renal stones < 3 cm: intelligent pressure-controlled ureteral access sheath (IPC-UAS) with flexible ureterolithotripsy (FURL), FURL alone, and percutaneous nephrolithotomy (PCNL). MATERIALS AND
methodsWe retrospectively analyzed 293 patients with renal stones treated at the Affiliated Hospital of Qingdao University, Qingdao, China, (December 2023–December 2024), stratified into IPC-UAS, FURL, and PCNL groups. Inclusion required preoperative diagnosis and postoperative imaging. Primary outcomes were stone-free rate (SFR) and residual stones; secondary outcomes included operative time, postoperative hospital stay, total length of stay, postoperative WBC count, neutrophil percentage, procalcitonin (PCT), hemoglobin difference, hospitalization costs, and postoperative complications (fever, bleeding).
resultsBaseline characteristics (gender, age, modified RUSS score, preoperative creatinine, collecting system dilation, largest stone diameter, stone number, CT Hounsfield units) showed no significant intergroup differences. The main results are as follows: SFR: IPC-UAS vs. FURL vs. PCNL = 1.00 [1.00, 1.00] vs. 1.00 [0.75, 1.00] vs. 1.00 [1.00, 1.00] (p < 0.01). Residual stones count: 0.00 [0.00, 0.00] vs. 0.00 [0.00, 1.00] vs. 0.00 [0.00, 0.00] (p < 0.01). Furthermore, SFR: IPC-UAS vs. FURL (p < 0.01), IPC-UAS vs. PCNL (p = 0.533). Residual stones count: IPC-UAS vs. FURL (p < 0.01), IPC-UAS vs. PCNL (p = 0.391). IPC-UAS and FURL showed comparable operative time, postoperative hospital stay, total length of stay, postoperative WBC counts, hemoglobin difference, PCT, and hospitalization costs. However, compared to PCNL, IPC-UAS demonstrates more favorable intraoperative and postoperative outcomes in all these metrics.
conclusionsIPC-UAS combined with FURL demonstrates superior SFR, faster recovery, and reduced patient morbidity. It is a clinically viable option for renal stones < 3 cm.
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