ArticleWorld journal of urology2025
Lasing strategy and its influence on 30-day operative outcomes in flexible ureteroscopy with FANS: inferences from a real-world prospective multicenter study by EAU-endourology and AUSET.
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. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Vacuum-assisted versus conventional percutaneous sheaths in pediatric supine mini-PCNL: a comparative analysis.Urolithiasis · 2026Article
- Paradigm shifts in fluid management using suction irrigation pressure autoregulating systems in modern flexible ureteroscopy with flexible and navigable suction access sheath: an evidence-based narrative from EAU Endourology.Current opinion in urology · 2026Review
- Safety and Efficacy of Flexible Ureteroscopy for Renal Stone Disease in Elderly Patients: A Scoping Review.Journal of clinical medicine · 2026Review
- Reply to the letter for "Lasing strategy and its influence on 30-Day operative outcomes in flexible ureteroscopy with FANS: inferences from A Real-World prospective multicenter study by EAU-Endourology and AUSET".World journal of urology · 2026Article
- How to interpret different lasing strategy results in retrograde intra renal surgery using flexible and navigable Suction access sheath?World journal of urology · 2026Article
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32 authors.
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Abstract
purposeTo compare operative and 30-day outcomes of dusting versus popcorning lithotripsy during flexible ureteroscopy (FURS) with flexible suction ureteral access sheaths (FANS) in a real-world multicenter study.
methodsThis prospective analysis included 704 adults from 21 centers undergoing FURS for kidney stone with FANS between August 2023 and August 2024. Patients were stratified by lasing strategy into dusting (n = 281) or popcorning (n = 423). Operative parameters, complications, and stone-free status (SFS) at 30 days-assessed by 2 mm slice non-contrast CT scan were compared. Multivariable logistic regression identified predictors of complete clearance (no fragment).
resultsPatients in the popcorning group presented with larger and denser stones (> 2 cm: 20.7% vs. 10.7%, p = 0.007; median HU 1100 vs. 1051, p = 0.003). Operative times were consistently longer with popcorning, including lasing (17 vs. 14 min), ureteroscopy (34 vs. 30 min), and overall duration (50 vs. 44 min, all p < 0.001). Safety outcomes were comparable, although ureteric injury related to sheath placement was observed exclusively in the dusting group (6.8% vs. 0%, p < 0.001). At 30 days, dusting demonstrated superior outcomes: complete clearance (69.4% vs. 53.9%, p < 0.001), and lower reintervention rates (2.1% vs. 5.7%, p = 0.037). Multivariable analysis using sequentially adjusted models confirmed stone volume as a negative predictor of clearance (OR 0.76-0.81, p ≤ 0.005), while use of Thulium fiber and pulsed Thulium: YAG lasers increased odds of achieving zero residual fragments.
conclusionDusting was associated with higher stone-free rates and fewer reinterventions compared with popcorning. However, laser technology, rather than lasing strategy, was the strongest predictor of outcomes, underscoring the need for individualized treatment planning.
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