Journal of endourology最新文献

{"title":"Intraoperative Cone Beam Computed Tomography Increases Single Procedure Stone-Free Rates in Percutaneous Nephrolithotomy: Results of a Randomized Controlled Trial.","authors":"Stijn Roemeling, Riemer A Kingma, Chris A Suijker, Emanuela Altobelli, Mieke T J Bus, Marcel J W Greuter, Shekar V K Mahesh, Igle J de Jong","doi":"10.1089/end.2024.0785","DOIUrl":"https://doi.org/10.1089/end.2024.0785","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Achieving a stone-free status during percutaneous nephrolithotomy (PCNL) is crucial to prevent additional morbidity or stone growth. Cone beam computed tomography (CBCT) in a hybrid operating room provides intraoperative imaging of the urinary tract, improving stone-free status assessment and enabling additional stone extraction. This study aimed to determine whether intraoperative CBCT leads to increased stone-free rates (SFR) after PCNL. <b><i>Materials and Methods:</i></b> We conducted a two-arm randomized trial involving adult patients undergoing PCNL at a tertiary referral center for complex kidney stone treatment. Intraoperative randomization took place when the kidney was deemed endoscopically stone free. Patients were assigned to either undergo an intraoperative CBCT scan or be placed in a control group, in which the procedure was ended without a CBCT scan. All patients underwent a low-dose noncontrast abdominal CT scan 4 weeks postoperatively. The primary outcome measure was the stone-free status evaluated by this scan. <b><i>Results:</i></b> This trial was prematurely terminated because of reaching the predefined criteria for superiority upon interim analysis, with 160 randomizations up to this point. SFR was 15% higher in the CBCT group (76% <i>vs</i> 61%, <i>p</i> = 0.04) using a 4-mm cut-off. With a 2-mm cut-off, the SFR difference was 14% (58% <i>vs</i> 44%, <i>p</i> = 0.08). Using a 0-mm cut-off, the difference was 9% (50% <i>vs</i> 41%, <i>p</i> = 0.27). Residual fragments were identified in 56% of CBCT scans, with additional extraction in 49% of these cases. No significant difference in 30-day postoperative complications was observed. <b><i>Conclusion:</i></b> Intraoperative CBCT during PCNL significantly increases single procedure SFR. <b><i>Trial registration:</i></b> Netherlands Trial Register (NTR) NL8168, ABR NL70728.042.19. Prospectively registered on 15 October 2019.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Comment on \"Enhanced Artificial Intelligence in Bladder Cancer Management: A Comparative Analysis and Optimization Study of Multiple Large Language Models\".","authors":"Shubham Kumar, Rachana Mehta, Ranjana Sah","doi":"10.1089/end.2025.0277","DOIUrl":"https://doi.org/10.1089/end.2025.0277","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Fragmentation while Minimizing Thermal Injury Risk with the Thulium Fiber Laser in Ureteral Stone Lithotripsy: An In Vitro Study.","authors":"Arpit Mishra, Ezra J Margolin, Aaron W Stewart, Robert E Medairos, Jodi Antonelli, Glenn M Preminger, Pei Zhong, Michael E Lipkin","doi":"10.1089/end.2024.0637","DOIUrl":"https://doi.org/10.1089/end.2024.0637","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To optimize thulium fiber laser (TFL) settings for effective stone fragmentation although minimizing thermal injury in confined ureteral spaces using a three-dimensional ureter model. <b><i>Materials and Methods:</i></b> A hydrogel-based ureter model was maintained at 37.2 ± 0.5°C, with a cylindrical BegoStone (10 × 10 mm, 1.00 ± 0.07 gm) occluding the ureter. Ureteroscopy was performed using a 150 µm TFL fiber for 3 minutes with room temperature irrigation and differing rates (0, 20, 40 mL/min) and power settings (6.4 to 20 W). Maximum sustained temperature (MST) and cumulative thermal dose (cumulative equivalent minutes at 43°C) were assessed against a 120-minute safety threshold. We also evaluated the effects of ureter volume and irrigation temperature. Stone mass treated was calculated by subtracting the mass of residual fragments >3 mm from the initial mass. <b><i>Results:</i></b> At 6.4 and 10 W, MSTs were below body temperature, and thermal doses were under 1 minute, indicating minimal thermal risk. At 20 W with 20 mL/min irrigation, MST exceeded 43°C within seconds, and thermal doses surpassed 120 minutes. Treatment efficiency was highest at 20 W (1.58 mg/s), followed by 10 W (1.15 mg/s) and 6.4 W (0.78 mg/s). Among 10 W settings, 1.0 J/10 Hz was more efficient than 2.0 J/5 Hz and 3.0 J/3 Hz. Safe settings produced 95.5% fine dust, whereas high-energy pulses 2-3 J produced significantly more fragments (1-3 mm) compared with settings with pulse energy 0.5-1.0 J. Increasing irrigation to 40 mL/min or using 15°C irrigation effectively reduced MST and improved efficiency, particularly at 20 W. <b><i>Conclusion:</i></b> Our study demonstrates the risk of thermal injury with 20 W TFL treatment. Conversely, 10 W settings at 2.0 J/5 Hz are safe and effective for fragmentation. Future research will focus on validating these optimal settings for human stone treatment.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing the Minimal Clinically Important Difference for the Wisconsin Stone Quality of Life Questionnaire Using Distribution- and Anchor-Based Methods.","authors":"Carl A Ceraolo, David Song, Victor Sandoval, Soumya Konar, Changyong Feng, Rajat K Jain, Kristina L Penniston, Scott O Quarrier","doi":"10.1089/end.2025.0028","DOIUrl":"https://doi.org/10.1089/end.2025.0028","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> The Wisconsin Stone Quality of Life (WISQOL) questionnaire is a survey-based tool that has been used to show worse health-related quality of life due to stone disease. The minimum clinically important difference threshold for determining whether changes in the WISQOL tool are meaningfully significant has not previously been estimated. Our study aimed to determine this threshold using distribution- and anchor-based methods. <b><i>Materials and Methods:</i></b> A retrospective single-center cohort of patients at a kidney stone clinic was administered the WISQOL questionnaire at initial and follow-up visits from January 2018 to November 2023. Baseline characteristics and WISQOL standardized scores and subdomain scores were recorded. Distribution-based estimates were calculated at the initial visit and at follow-up. Three anchor questions were used to create a global transition question scale. Cross-sectional, longitudinal within-group, and longitudinal between-group anchor-based estimates were calculated. <b><i>Results:</i></b> The cohort included 1197 individuals with both an initial clinic visit and a follow-up visit. The distribution-based minimum clinically important difference estimates ranged from 3.5 to 10.8. Cross-sectional anchor-based estimates ranged from 3.1 to 13.6. Within-group anchor-based estimates for improvement ranged from 8.5 to 10.3 and for deterioration ranged from 3.1 to 6.3. Between-group anchor-based estimates for improvement were 9.1 (adjusted confidence interval [CI]: 7.5-10.8) and for deterioration were 4.2 (adjusted CI: 2.3-6.1). <b><i>Conclusions:</i></b> A conservative threshold for clinical significance in total WISQOL score (standardized to scale of 0-100) is a difference of 9 for both improvement and deterioration. These findings can be used to further implement WISQOL in guiding clinical decision-making.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Present Insights and Future Perspectives in Pediatric Percutaneous Nephrolithotomy: A Systematic Review by the EAU-YAU Pediatric Urology Working Group.","authors":"Yesica Quiroz Madarriaga, Muhammet İrfan Dönmez, Rianne J M Lammers, Beatriz Bañuelos Marco, Numan Baydilli, Edoardo Bindi, Simone Sforza, Lisette Aimée 't Hoen","doi":"10.1089/end.2024.0727","DOIUrl":"https://doi.org/10.1089/end.2024.0727","url":null,"abstract":"<p><p><b><i>Background and Objective:</i></b> The incidence of stone disease in children has risen worldwide, leading to the development of more treatment options. Percutaneous nephrolithotomy (PCNL) is often the preferred approach in many pediatric cases. This systematic review aims to assess the effectiveness and safety of PCNL in children, as well as to identify future directions for improving procedural outcomes. <b><i>Methods:</i></b> For this systematic review a comprehensive electronic search was conducted in PubMed and EMBASE in August 2023. The search included patients younger than 18 with renal stones requiring any modality of PCNL, as well as to establish the deficiencies in the reports of outcomes. The search strategy adhered to PRISMA guidelines, and quality assessments were performed using the Cochrane tool and MINORS tool. <b><i>Key Findings and Limitations:</i></b> Regardless of age, PCNL is safe and efficient in children, with stone-free rate above 85% and complication rate below 7%. However, neither the definition of stone free nor the way of reporting complications is homogeneous among studies. In addition, aspects such as diagnostic imaging, antibiotic prophylaxis, postoperative drainage, metabolic study, or follow-up are not systematically or uniformly reported in the studies. <b><i>Conclusions and Clinical Implications:</i></b> PCNL maintains its efficiency and safety even when the working tract caliber is reduced. However, the lack of standardization when describing pre-, peri-, and postoperative aspects creates a gap that does not allow grouping outcomes and highlights the lack of clear guidelines when implementing this surgical procedure.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Stone Composition in Irrigation Fluid Using Raman Spectroscopy: A Blinded Comparative Study.","authors":"Orit Raz, Iddo Pinkas, Amir Cooper, Dor Golomb","doi":"10.1089/end.2025.0088","DOIUrl":"https://doi.org/10.1089/end.2025.0088","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> To assess the capability of Raman spectroscopy (RS) in the analysis of stone composition utilizing microscopic fragments from irrigation fluid during ureteroscopy (URS) and laser lithotripsy. <b><i>Patients and Methods:</i></b> A prospective, blinded study involving patients undergoing URS with laser lithotripsy. Irrigation fluid collected during the procedure was centrifuged, and microscopic particles were analyzed using RS. Simultaneously, stone fragments underwent formal analysis by Fourier-transform infrared spectroscopy (FTIR) in a different laboratory. The researcher conducting the RS was blinded to the results of the FTIR analysis. The RS results were compared with FTIR to evaluate concordance. <b><i>Results:</i></b> Between March 2022 and February 2023, 22 patients were enrolled. Stones were located in the kidney (41%), ureter (45%), and both (14%). The median stone size was 12 mm. RS accurately identified the major stone component in 82.6% (19) of cases, with a 17.4% (3) discrepancy. Concordance was observed for stones composed of calcium oxalate (CaOx) monohydrate/dihydrate, calcium phosphate, and uric acid. In discordant cases, FTIR identified CaOx monohydrate and dihydrate. <b><i>Conclusions:</i></b> This study introduces an innovative approach for analyzing stone composition using microparticles from irrigation fluid during stone fragmentation. The results demonstrated strong concordance with the standard FTIR technique, suggesting potential for stone analysis without the need to retrieve fragments during procedures. Further research is warranted to refine this method for broader clinical application.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trifecta of Same-Day Discharge after Single-Port Robotic-Assisted Simple Prostatectomy.","authors":"Hakan Bahadir Haberal, Luca Lambertini, Matteo Pacini, Giulio Avesani, Fabio Maria Valenzi, Muhannad Aljoulani, Ruben Calvo Sauer, Juan Ramon Torres-Anguiano, Simone Crivellaro","doi":"10.1089/end.2024.0930","DOIUrl":"10.1089/end.2024.0930","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> There are numerous options available for the surgical treatment of benign prostate hyperplasia, and single-port robotic-assisted simple prostatectomy (SP-RASP) has emerged as a novel method in this field. In this study, we aim to define the trifecta of same-day discharge (SDD) and identify the factors associated with the trifecta of SDD following SP-RASP. <b><i>Materials and Methods:</i></b> Data from 95 patients who underwent SP-RASP between February 2020 and July 2024 at a single center by a single surgeon were evaluated. The trifecta of SDD was defined as a patient being discharged on the same day without experiencing any 90-day postoperative complications and no readmissions. The factors associated with predicting the trifecta of SDD were investigated. <b><i>Results:</i></b> A total of 95 SP-RASP cases were successfully performed without the need for conversion to alternative approaches, and 54 patients (56.8%) were included in the trifecta of the SDD-achieved group. The reasons for failure included 23 patients (24.2%) requiring postoperative hospitalization from the recovery area, 24 patients (25.3%) experiencing postoperative complications, and 2 patients (2.1%) needing readmission within 90 days after discharge. There was a 0% incidence of major postoperative complications (≥Clavien-Dindo grade 3). When comparing the groups, trifecta-achieved patients showed lower estimated blood loss, smaller specimen weight, lower percentage of adenoma removed, and a reduced rate of opioid prescriptions at discharge (<i>p</i> = 0.005, 0.033, 0.025, and 0.026, respectively). In the multivariate logistic regression analysis, specimen weight was the only factor significantly associated with trifecta following SP-RASP (<i>p</i> = 0.018). <b><i>Conclusion:</i></b> In our cohort, 56% of patients were classified within the trifecta group, with no major postoperative complications observed following SP-RASP. Specimen weight was the only independent predictor of trifecta achievement in these patients.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"477-481"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ureteroscopy and Laser Lithotripsy for Large (≥2 cm) Upper Tract Urinary Stones in Pediatric Patients: Outcomes from a Pediatric Endourology Referral Center.","authors":"Victoria Jahrreiss, Stephen Griffin, Bhaskar Somani","doi":"10.1089/end.2024.0587","DOIUrl":"10.1089/end.2024.0587","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The global prevalence of pediatric urolithiasis is increasing. Managing large urinary stones in pediatric populations poses a particular clinical challenge. This study evaluates the safety and efficacy of ureteroscopy and laser stone fragmentation (URSL) for treating large upper urinary tract stones in pediatric patients. <b><i>Methods:</i></b> A retrospective analysis of the prospective database was conducted on pediatric patients who underwent URSL for stones ≥2 cm between 2011 and 2023 (14 years) at the University Hospital Southampton, UK. Patient demographics, stone characteristics, operative details, stone-free rates (SFR), and complications were analyzed. <b><i>Results:</i></b> In total, 23 patients (median age 11 years) underwent URSL. The mean total stone length was 24.7 ± 6.49 mm, with 12 (52.2%) having multiple stones. Prestenting, ureteral access sheath, and postop stenting were used in 9 (39.1%), 4 (17.4%), and 10 patients (43.5%), respectively. Holmium laser was used, and the SFR after the first procedure was 91.3%, with no procedural complications. There was only one complication (postoperative fever, Clavien-Dindo I) reported. The median length of stay was 1 day. <b><i>Conclusion:</i></b> URSL is safe and efficient for treating large upper tract urinary stones in pediatric patients, demonstrating high SFR and low complication rate. This could offer an alternative treatment modality to percutaneous surgery in large upper urinary tract stones, although parents need to be adequately counseled about it.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"432-437"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amount of Ipsilateral Parenchymal Volume Preserved Is a Key Determinant of Split Renal Function after Robot-Assisted Partial Nephrectomy.","authors":"Ken Kawada, Kojiro Ohba, Masaharu Oki, Yuta Mukae, Hiromi Nakanishi, Kensuke Mitsunari, Tomohiro Matsuo, Yasushi Mochizuki, Ryoichi Imamura","doi":"10.1089/end.2024.0857","DOIUrl":"10.1089/end.2024.0857","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To identify factors associated with preserved split renal function (SRF) after robot-assisted partial nephrectomy (RAPN). <b><i>Patients and Methods:</i></b> The study included patients who underwent RAPN at Nagasaki University Hospital between November 2016 and December 2023. SRF was determined by 99mTc-dimercaptosuccinic acid renal imaging and the estimated glomerular filtration rate, with measurements obtained before and 6 months after surgery. The ipsilateral parenchymal volume (IPV) was measured at the same time. More than 90% SRF after surgery was considered to indicate successful preservation of renal function (the successful group), and ≤90% SRF was considered failure to preserve renal function (the unsuccessful group). The factors most relevant to SRF were sought in univariate and multivariate analyses. <b><i>Results:</i></b> Data for a total of 169 patients were analyzed. The median SRF was 32.04 mL/min/1.73 m² (interquartile range [IQR] 25.95, 38.06) before surgery and 27.33 mL/min/1.73 m² (IQR 21.64, 34.32) after surgery. The median SRF preservation rate was 88% (IQR 78.4, 97.0), with 94 cases (55.6%) having SRF >90% and 75 cases (44%) having SRF ≤90%. The median IPV on the surgical side was calculated by the software to be 152.2 cm³ (IQR 126.9, 186.6) preoperatively and 127.3 cm³ (IQR 102.9, 161.3) postoperatively, with a median preservation rate of 84.6% (IQR 72.2, 89.7). Univariate analysis showed significant between-group differences in diabetes status, RENAL Nephrometry score, operation time, warm ischemia time, whether or not parenchymal sutures were needed, and the amount of IPV preserved. Only percentage of IPV preserved remained significant in multivariate analysis. <b><i>Conclusion:</i></b> The findings of this study suggest that the residual IPV is an important determinant of SRF after RAPN.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"482-487"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Anteriorly Located Renal Caliceal Stones with Two Different Techniques (Mini-Percutaneous Nephrolithotomy <i>vs</i> Flexible Ureteroscopic Laser Lithotripsy): A Critical Comparative Evaluation of the Outcomes.","authors":"Ferhat Yakup Suçeken, Murat Akgül, Elif Ertaş, Ali Selim Durmaz, Emre Burak Şahinler, Alper Aşık, Hikmet Yaşar, Eyüp Veli Küçük, Kemal Sarıca","doi":"10.1089/end.2024.0888","DOIUrl":"10.1089/end.2024.0888","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> To evaluate the efficacy and safety of two different approaches, flexible ureteroscopic laser lithotripsy (fURS) and mini-percutaneous nephrolithotomy (mini-PCNL), for the minimally invasive management of anteriorly located caliceal stones in a location-based manner. <b><i>Materials and Methods:</i></b> A total of 93 patients with anterior caliceal stones (<15 mm) were treated with following two different modalities: fURS (<i>n</i> = 52, 55.9%) (Group 1) and mini-PCNL (<i>n</i> = 41, 44.1%) (Group 2). Demographic, per-operative, and postoperative parameters were comparatively evaluated in both groups. <b><i>Results:</i></b> The groups were similar in terms of their demographic data and stone characteristics (<i>p</i> > 0.05). Operation, fluoroscopy time, and hospital stay were significantly longer in Group 2 (<i>p</i> < 0.001). The perioperative complication and overall stone-free rates were similar between the groups (<i>p</i> = 0.44 and <i>p</i> = 0.53, respectively). However, when the stone-free rates were examined according to the calix groups, Group 2 was significantly more effective in terms of stone-free rates in the lower calix (52% <i>vs</i> 84%, <i>p</i> = 0.03). Although not statistically significant, more postoperative complications were observed in Group 2 (<i>p</i> = 0.09). <b><i>Conclusion:</i></b> Our findings demonstrate that although mini-PCNL may be performed well through a caliceal puncture to remove lower caliceal stones with a high stone clearance rate, the fURS approach may be safer and more rational for the removal of stones located in the middle and upper anterior calices.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"451-456"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}