A retrospective comparison of Sun's tip-flexible semirigid ureterorenoscopy, super-mini percutaneous nephrolithotomy and flexible ureteroscopy applied to treat upper urinary tract calculi

BackgroundThis retrospective study was conducted to compare the safety and efficacy of Sun's tip-flexible semirigid ureterorenoscopy (tf-URS), super-mini percutaneous nephrolithotomy (SMP) and flexible ureteroscopy (FURS) in treating upper urinary tract calculi, including upper ureteral or renal calculi. MethodsWe included patients with upper ureteral calculi or renal calculi 1.0-2.0 cm in size, who underwent tf-URS, SMP or FURS, respectively. The indicators reflecting safety and efficacy were compared among the three surgical techniques. ResultsSMP presented with higher single stone crushing success rate, but longer operation time and postoperative hospital stay, more blood loss, and higher postoperative pain score compared with FURS and tf-URS (P < 0.05). The hospitalization cost of tf-URS group was lower than that of SMP and FURS groups (P < 0.05). The incidence of postoperative fever in tf-URS group was significantly higher than that in SMP group (P < 0.05). No significant difference was found in mucosal injury, perirenal hematoma, and stone-free rate at 3 months after surgery (P > 0.05). Conclusionstf-URS and FURS have the advantages in minimal invasion, hospitalization cost, patient comfort, and hospital stay while SMP has higher stone-free rate. These three surgical techniques are safe, reliable and complementary, which should be selected according to the actual situation.