Prospective multicenter real-world outcomes of Suction Technology Utility in Mini-PCNL Study (STUMPS) in modern-day practice: formulation of the global STUMPS registry on behalf of the endourology section of the European Association of Urology and the suction mini-PCNL collaborative study group.

Abstract

Purpose: To present outcomes of a registry to understand the practice patterns, resource utilization, and nuances of suction mini-percutaneous nephron lithotripsy (SM-PCNL).

Methods: Data from 30 centers in 21 countries were prospectively collected (March-November 2024). SM-PCNL was defined as PCNL using a suction nephrostomy sheath of size 14-22 Fr. with any lithotripsy device. There were no instructions on how to perform the surgical procedure. Stone features and stone-free status were assessed using an unenhanced CT scan. Data are presented as median/interquartile range and frequency/proportion.

Results: 1707 patients were included and 42.4% of them were males. Most were first-time stone formers. Median age was 50 years. Median stone volume was 1700 mm³. Surgery was commonly performed using a single access tract (92.9%) and in supine position (56.5%). The fluoroscopy-only puncture was used as the most common access (70.7%), followed by the combination of fluoroscopy and ultrasound (25.1%). Median operation time was 45 min. The most common sheath was Clearpetra (27.8%). Thulium fiber laser was the most frequent energy used (26.2%). A tubeless procedure with a stent was employed in 47.0% of cases. Most common complications were fever managed by observation (7.3%), fever requiring antibiotics (3.3%), blood transfusion (1.1%), and sepsis (0.2%). Median hospitalization was 3 days. 30-day CT scan showed zero fragments in 82.4% of patients. Reintervention was performed in 2.6% of cases.

Conclusions: This registry outlines the various equipment, peri-operative strategies, complications, and outcomes of SM-PCNL performed in real-world practice, providing valuable data on the nuances of performing such surgery.