ArticleBMC urology2026
Flexible negative-pressure ureteral sheath lithotripsy compared with mini-PCNL for upper urinary tract stones with moderate-to-severe hydronephrosis: a retrospective clinical study.
Article in BMC urology, 2026. 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
backgroundManagement of upper urinary tract stones with moderate-to-severe hydronephrosis remains challenging due to altered renal anatomy and higher complication risks. Flexible negative-pressure ureteral sheath lithotripsy (FANS) has emerged as a minimally invasive alternative to miniaturized percutaneous nephrolithotomy (mini-PCNL). This study compared the efficacy and safety of FANS and mini-PCNL in this patient population.
methodsA total of 125 patients with upper urinary tract stones and moderate-to-severe hydronephrosis who underwent either FANS (n = 57) or mini-PCNL (n = 68) between June 2024 and June 2025 were retrospectively analyzed. Baseline demographics, stone characteristics, operative parameters, perioperative laboratory changes, hospital stay, immediate stone-free rate (SFR) and finial SFR, and postoperative complications were assessed.
resultsBaseline characteristics (age, BMI, stone burden, comorbidities, and hydronephrosis degree) were comparable between groups. The FANS group had a longer operative time (70 vs. 60 min, P = 0.006) but a shorter stay of hospital (2 vs. 3 days, P = 0.008) and smaller hemoglobin drop (8.0 vs. 11.0 g/L, P = 0.031). WBC changes, eGFR drop, immediate SFR (80.7% vs. 80.9%) and finial SFR (89.5% (51/57) vs. 88.2% (60/68)) were similar. The overall complication rate was lower with FANS (5.9% (4/57) vs. 25.0% (17/68), P = 0.011), and no severe complications occurred, whereas mini-PCNL included several Grade 3b events.
conclusionsBoth FANS and mini-PCNL achieved comparable stone clearance in moderate-to-severe hydronephrosis. However, FANS offered reduced bleeding, faster recovery, and fewer complications, indicating its potential role as a safer and less invasive option for patients with complex upper urinary tract anatomy.
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