Lower pole stones relocation during flexible ureteroscopy improves outcome

A recent study published in the World Journal of Urology uncovered a promising relocation technique to improve outcomes in the treatment of lower pole renal stones. This study by Ru Huang and team was conducted from January 2020 to November 2022 and focused on comparing the efficacy and safety of relocating lower pole stones during flexible ureteroscopy (FURS) with in situ lithotripsy.

The research enrolled a total of 90 patients with 10 to 20 mm lower pole renal stones who were randomly assigned them to either a relocation group or an in situ group. In the relocation group, the stones were relocated into a calyx during lithotripsy, while the in situ group underwent FURS without relocation. All procedures were performed by the same surgeon which ensured consistency in execution.

The findings of this study revealed that both groups had similar perioperative parameters, complications, and overall costs. The relocation group expressed a significantly higher stone-free rate (SFR) three months postoperatively compared to the in situ group (97.8% vs. 84.4%, p = 0.026). The SFR at one day postoperative follow-up was also similar between the two groups (p = 0.091). Also, the relocation group demonstrated a significantly higher quality of life score (WisQol) when compared to the in situ group (126.98 vs. 110.18, p < 0.001).

The relocation technique did not increase the mean operation time, total energy consumption, postoperative stay or complications by highlighting that the improved outcomes were achieved without compromising other aspects of the entire procedure. These outcomes suggests that the relocation technique during FURS procedures could be a potential strategy and can offer patients an increased stone-free rate and improved quality of life postoperatively.

Source:

Huang, R., Chen, J.-C., Zhou, Y.-Q., Wang, J.-J., Hui, C.-C., Jiang, M.-J., & Xu, C. (2024). Relocation of lower pole renal stones helps improve the stone-free rate during flexible ureteroscopy with a low complication rate. World Journal of Urology, 42(1). https://doi.org/10.1007/s00345-023-04703-6