Photo Credit: Mohammed Haneefa Nizamudeen

The following is a summary of “Comparison of two negative pressure ureteral access sheaths combined with day-case flexible ureteroscopy for renal stones randomized trial,” published in the November 2024 issue of Urology by Ma et al. 

Researchers conducted a retrospective study to compare the safety and effectiveness of intelligent intrarenal pressure control combined with flexible ureteroscopic lithotripsy (FURL) for renal stones less than 2 cm. 

They conducted a prospective, randomized, double-blind, parallel-controlled study from November 2023 to July 2024, enrolling 60 patients with upper urinary tract calculi ≤ 2 cm. Patients were randomly assigned to either the intelligent pressure control group (IFURL, n = 30) or the head bending group (BFURL, n = 30) using a pre-generated random number table and SPSS 27.0. Blinding was implemented for patients, data collectors, statisticians, and analysts, with allocation results disclosed to surgeons before the procedure. 

The results showed that the operation duration for IFURL and BFURL was 52.50 (48.00, 60.00) vs 46.00 (36.00, 56.25), respectively (P = 0.047). Stone-free rate (SFR) on the first postoperative day was 73.33% vs 93.33% (P = 0.038), with no significant difference after 2 months (90.00% vs. 96.67%, P = 0.301). About 1 patient in IFURL was readmitted for fever, and 1 in BFURL for pain due to urine extravasation, both improved with treatment. 

Investigators found that SFR 1 month post-surgery for renal calculi ≤ 2 cm treated with intelligent pressure control and flexible ureteral access sheaths (UAS) was similar for both groups, with low infection-related complications and rehospitalization rates. However, overall hospitalization costs were lower for the BFURL group than for the IFURL. 

Source: nature.com/articles/s41598-024-80934-w