Comparison of ultrasonic lithotripsy with Ho:YAG laser lithotripsy during percutaneous nephrolithotomy for 20-40 mm low-hardness renal calculi: a propensity score-matched study.

Gaoyuanzhi Yue, Xueqing Zeng, Jiapeng Liu, Renfei Liu, Fuyang Lin, Tao He, Yongda Liu

Abstract readComparative Study

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Article in World journal of 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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7 authors.

Gaoyuanzhi YueDepartment of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China.

Xueqing ZengDepartment of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China.

Jiapeng LiuDepartment of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China.

Renfei LiuDepartment of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China.

Fuyang LinDepartment of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China.

Tao HeDepartment of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China. nxhetao@126.com.

Yongda LiuDepartment of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China. 13719007083@163.com.ORCID https://orcid.org/0000-0003-2032-1314

Funding

Science and Technology Program of Guangzhou, China No. 202201020511

6 · The paper itself

Abstract

purposeThis study aims to compare the efficacy and safety of ultrasonic lithotripsy (UL) with an integrated suction system versus holmium: yttrium-aluminum-garnet (Ho:YAG) laser lithotripsy during percutaneous nephrolithotomy (PCNL) for treating 20-40 mm low-hardness renal stones using propensity score matching (PSM) analysis.

methodsThis single-center retrospective cohort study included 436 patients undergoing PCNL for 20-40 mm low-hardness stones. PSM balanced baseline characteristics, comparing patients treated with an ultrasonic lithotripsy system equipped with an integrated suction system (UL group, n = 110) and Ho:YAG laser lithotripsy (Ho:YAG group, n = 110) regarding 1-day/1-month stone-free rates (SFR), operative time, and complications.

resultsThe UL group exhibited a significantly higher 1-day SFR (96.36% vs. 85.45%, P = 0.005). The 1-month SFR was numerically higher in the UL group than in the Ho:YAG group (96.36% vs. 90.00%), although the difference did not reach statistical significance (P = 0.061). Complication rates were lower in the UL group (7.27% vs. 22.73%, p = 0.001), particularly for low-grade Clavien I-II events. Postoperative pain (VAS) at 6 h was higher in the UL group (7.24 ± 1.53 vs. 6.67 ± 1.97, p = 0.018), yet comparable at 24/48 hours. Hemoglobin drop, operative time, and hospitalization showed no intergroup differences.

conclusionUL demonstrates superior early SFR and safety for 20-40 mm low-hardness stones, suggesting that it has the potential to facilitate stentless PCNL. Prospective studies are warranted to validate these findings and optimize clinical protocols.

Indexed as

Kidney CalculiLasers, Solid-StateLithotripsyLithotripsy, LaserNephrolithotomy, PercutaneousAdultFemaleHumansMaleMiddle AgedPropensity ScoreRetrospective StudiesTreatment OutcomeHolmium:YAG laser lithotripsyKidney stonePercutaneous nephrolithotomyStone-free rateUltrasound lithotripsy

Identifiers

PMID42752701

DOI10.1007/s00345-026-06771-w

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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.