Comparative Efficacy on Flexible Ureteroscopy Lithotripsy and Miniaturized Percutaneous Nephrolithotomy for the Treatment of Medium-Sized Lower-Pole Renal Calculi.

To demonstrate the safety and efficacy of flexible ureteroscopy lithotripsy (FURL) and miniaturized percutaneous nephrolithotomy (MPCNL) through the comparative studies in treating medium-sized lower-pole renal calculi. Two hundred and twenty eligible patients with lower-pole renal calculi (1-2 cm) were enrolled and further randomly assigned into FURL group and MPCNL group. Patients' demographics, preoperative characteristics, intraoperative and postoperative complications, stone-free rate, and comfort and pain indicated by Bruggrmann Comfort Scale (BCS) and visual analog scale (VAS) were evaluated and recorded. Trauma index such as white blood cells, C-reactive protein (CRP), and interleukin (IL)-6 were also detected. The stone-free rate and the operating time were comparable in FURL and MPCNL groups. Intraoperative and postoperative complication analysis showed that blood loss and hospital stay were significantly lower in the FURL group compared with MPCNL group. No significant difference in minor pelvic perforation, false passage, hemoglobin drop, persistent hematuria, ureteral perforation, moderate fever, urosepsis, and postoperative serum creatinine level was observed. However, as to comfort and pain indicated by BCS and VAS and stress indicated by CRP and IL-6, FURL was superior to MPCNL. FURL could be a better alternative surgical method to MPCNL with similar curative effect and less blood loss and hospital stay.