Comparison between Tubeless Mini-Percutaneous Nephrolithotomy versus Flexible Ureterorenoscopic Lithotripsy for the Treatment of Upper Ureteral Calculi Larger than 1 cm

Abstract

To assess the outcome and safety of tubeless mini-percutaneous nephrolithotomy (mPCNL) and flexible ureterorenoscopic lithotripsy (fURSL) in treating upper ureteral stones larger than 1 cm. Between July 2017 and June 2020, 218 patients underwent tubeless mini-PCNL and fURSL for upper ureteral calculi larger than 1 cm were enrolled in this study. Patient characteristics and perioperative outcomes and complications were evaluated by retrospective chart review. Immediate stone-free rates after the procedure were 100 % of patients for the tubeless mini-PCNL and 71.0 % of patients for the fURSL group (P = 0.004). The mean operative time per patient was 79.8 ± 21.8 minutes in the tubeless mini-PCNL group, and it was 99.7 ± 33.8 minutes in the fURSL groups (P = 0.009). The average hospital stay was 2.7 ± 1.9 days in the tubeless mini-PCNL group and 1.5 ± 1.2 days in the fURSL group (P < 0.001). The rate of febrile episode for the tubeless mini-PCNL and fURSL groups were 14.3 % and 2.3%, respectively (P = 0.028) Tubeless mini-PCNL and fURSL are safe and feasible treatment options for proximal ureteral calculi larger than 1 cm. Tubeless mini-PCNL offers better outcome of higher stone-free rate and shorter operation time compared with fURSL, but with a higher rate of febrile complications and longer hospital stay.