Mini-PCNL (percutaneous nephrolithotomy) versus FURSL (flexible ureteroscopy and laser lithotripsy): A head-to-head comparison in treating calyceal diverticulum stones: A prospective randomized study.

Purpose: To compare the efficacy and safety of mini-percutaneous nephrolithotomy versus flexible ureteroscopy with laser lithotripsy in the management of calyceal diverticulum stones.

Methods: The study performed a prospective analysis of 91 patients with confirmed calyceal diverticulum stones in Saudi Arabia from January 2020 to June 2024. A total of 78 patients with CD (calyceal diverticulum) stones were randomly divided into two groups: Group A (n = 39) FURSL and Group B (n = 39) mini-PCNL. The study analyzed patient demographics, stone complexity, operative parameters, postoperative results, and postoperative outcomes, including stone-free rates, operative time, hospital stay, complication rates, and recovery time.

Results: Both groups showed similar baseline characteristics and surgical feasibility, with the mini-PCNL group showing a higher SFR (84.62% vs 71.79%), but not statistically significant. Hospital stay was significantly shorter in the FURSL group (17.31 ± 3.06 h vs 30.03 ± 7.18 h; p < 0.001). Patients undergoing FURSL returned to normal activity sooner (5.1 ± 1.37 days vs 8.03 ± 1.05 days; p < 0.05). Complication rates were low and nearly similar across groups.

Conclusions: Both mini-PCNL and FURSL are effective strategies for treating calyceal diverticulum stones. Notably, mini-PCNL offers superior stone-free rates, while FURSL offers shorter operative times, hospital stays, and fast recovery.