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RIRS with FV-UAS vs. MPCNL for 2–3-cm upper urinary tract stones: a prospective study

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Abstract

To observe the efficacy and safety of retrograde intrarenal surgery (RIRS) combined with flexible vacuum-assisted ureteral access sheath (FV-UAS) and minimally invasive percutaneous nephrolithotomy (MPCNL) in patients with 2–3 cm upper urinary tract stones. A total of 160 patients with 2–3 cm upper urinary tract stones were prospectively randomized into 2 groups—80 in the FV-UAS group and 80 cases as control in the MPCNL group. The stone-free rates (SFRs) at different times (postoperative 1st day and 4th week) were considered as the primary outcome of the study. The secondary end points were operative time, hemoglobin decrease, postoperative hospital stay, and operation-related complications. There was no obvious difference between the two groups in patient’s demographics and preoperative clinical characteristics (all P > 0.05). Postoperative data showed that mean decrease in hemoglobin level was less in FV-UAS group than that in MPCNL group (5.3 vs. 10.8 g/L, P < 0.001). Postoperative hospital stay in FV-UAS group was more shorten than that in MPCNL group (2.7 vs. 4.9 days, P < 0.001). There was no statistical significance between the two groups in SFRs during postoperative 1st day and 4th week (both P > 0.05). However, in terms of the rates of bleeding and pain, MPCNL group were both significantly higher than FV-UAS group (6.2 vs. 0.0%, P = 0.023; 16.2 vs. 2.5%, P = 0.003; respectively). Our study showed that RIRS with FV-UAS, a new partnership to treat 2–3 cm upper urinary tract stones, was satisfying as it achieved a high SFR rate and a low rate of complications. This method was safe and reproducible in clinical practice.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Du-Jian Wang, Ping Liang, Tian-Xiao Yang and Yi-Qing Liu are equally contributed to this article and are co-first authors.

Authors and Affiliations

  1. The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China

    Du-Jian Wang, Qing-Lai Tang, Xing-Zhu Zhou & Rong-Zhen Tao

  2. Nanjing Second Hospital, Nanjing, China

    Ping Liang

  3. The Affiliated Hospital of Chifeng University, Inner Mongolia, Chifeng, China

    Tian-Xiao Yang

  4. Guanyun People’s Hospital, Lian Yungang, China

    Yi-Qing Liu

Authors
  1. Du-Jian Wang
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  2. Ping Liang
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  3. Tian-Xiao Yang
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  4. Yi-Qing Liu
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  5. Qing-Lai Tang
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  6. Xing-Zhu Zhou
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  7. Rong-Zhen Tao
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Contributions

QL Tang and RZ Tao: project development. TX Yang and YQ Liu: data Collection. DJ Wang, P Liang, and XZ Zhou: data analysis and manuscript writing.

Corresponding author

Correspondence to Rong-Zhen Tao.

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Conflict of interest

The authors declare that they have no competing financial interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Affiliated Jiangning Hospital of Nanjing Medical University (ethics approval number: 202100446) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The clinical trial registration number for study is ChiCTR-INR-21013723.

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Informed consent was obtained from all individual participants included in the study.

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Wang, DJ., Liang, P., Yang, TX. et al. RIRS with FV-UAS vs. MPCNL for 2–3-cm upper urinary tract stones: a prospective study. Urolithiasis 52, 31 (2024). https://doi.org/10.1007/s00240-024-01539-6

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  • DOI: https://doi.org/10.1007/s00240-024-01539-6

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