Efficacy and safety of antegrade ureteroscopic lithotripsy versus retrograde ureteroscopic lithotripsy in the treatment of upper ureteric stones measuring > 10 mm in maximum dimension and/or impacted stones: randomized comparative study.

Mohamed Wishahi, Mohammad Attaby, Rafik El Halaby, Ahmad G Elbaz, Mohamed Hasan

Registry-linked trialAbstract readRandomized Controlled TrialComparative Study

In one paragraph

Trial report in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07362784 (Efficacy And Safety Of Antegrade Uretroscopic Lithotripsy Versus Retrograde Ureteroscopic Lithotripsy In The Treatment Of Upper Ureteric Stones Measuring > 10 mm In Maximum Dimension. A Randomized Comparative Study), which is not on this map. Not yet cited in PubMed.

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0citing papers in PubMed

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1 · What the graph read from it

What it found

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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.

NCT07362784 nacompletednot on this map

Efficacy And Safety Of Antegrade Uretroscopic Lithotripsy Versus Retrograde Ureteroscopic Lithotripsy In The Treatment Of Upper Ureteric Stones Measuring > 10 mm In Maximum Dimension. A Randomized Comparative Study

TypeinterventionalSponsorAin Shams UniversityRan2022 to 2025Enrolled100ConditionsUpper Ureteric StonesArmsantegrade flexible ureteroscopy for group A, retrograde flexible ureteroscopy For group B

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Mohamed WishahiDepartment of Urology, Theodor Bilharz Research Institute, Cairo, Egypt. wishahi@gmx.net.

Mohammad AttabyDepartment of Urology, Theodor Bilharz Research Institute, Cairo, Egypt.

Rafik El HalabyDepartment of Urology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Ahmad G ElbazDepartment of Urology, Theodor Bilharz Research Institute, Cairo, Egypt.

Mohamed HasanDepartment of Urology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare efficacy and safety of antegrade flexible ureteroscopic lithotripsy (fURSL) in treating proximal ureteric stone ˃ 10 mm in maximum diameter including impacted stones with the retrograde approach. PATIENTS AND MATERIALS: This randomized prospective comparative study conducted at high-volume hospitals in urology departments in Ain Shams university and Theodor Bilharz Research Institute from March 2022 to December 2025 and included 100 patients all having upper ureteric stone larger than 10 mm (˃10 mm) in maximum diameter. Patients were randomized into 2 groups; the antegrade fURSL (group A) and retrograde fURSL (group B). For stone disintegration flexible ureteroscope and holmium laser were used . Renal access tract was achieved in antegrade group in prone position. All patients had double J stent fixed at end of procedure.

resultsGroup A patients had higher stone-free-rate (SFR) than group B (92% Vs 74%) showing statistical significance (P = 0.027). This gap in SFR increases with focusing on subgroups of impacted stones (94.12% Vs 64.5%, P = 0.004). Group B patients required a significantly higher proportion of auxiliary treatment (18% Vs 4%, P = 0.02). Group B had significantly shorter operative and fluoroscopy times than group A (P <0.0001) and had significantly shorter hospital stay (P = 0.015). Mean hemoglobin drop in group A was higher than in group B with no statistical significance, no signs of bleeding were recorded nor the need for blood transfusion. Overall complications were higher in group B than in group A (P = 0.028). Complications rate was significantly related to failure of insertion of ureteral access sheath (UAS) in retrograde approach with odds ratio 14.7.

conclusionAntegrade fURSL is safe and effective modality to treat upper ureteric stones ˃10 mm mm in maximum diameter with higher SFR, less auxiliary procedures needed and favorable post-operative adverse events profile. Antegrade approach efficacy is augmented when focusing on treating impacted stones. CLINICAL

trial registrationClinicalTrials.gov ID NCT07362784.

Indexed as

LithotripsyUreteral CalculiUreteroscopyAdultFemaleHumansMaleMiddle AgedProspective StudiesTreatment OutcomeAntegrade ureteroscopyFlexible ureteroscopyLaser lithotripsyProximal ureteric stonesRetrograde ureteroscopyUreteral access sheath

Identifiers

PMID42086948

DOI10.1007/s00345-026-06445-7

What OpenQuestion holds

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Registered trials

NCT07362784ClinicalTrials.gov

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.