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Actively extracting kidney stones combined dusting technique can improve SFR of moderate-complexity kidney stones in fURL

  • Urology - Original Paper
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Abstract

Purpose

To evaluate the necessity and effectiveness of actively extracting kidney stones with different complexity that have been visually dusted in flexible ureteroscopic lithotripsy (fURL).

Methods

We retrospectively reviewed the medical records of patients who underwent fURL with dusting technique in established hospitals. A total of 535 cases were divided into the dusting group or the dusting plus basketing group according to the use of stone basket. Their characteristics and operative parameters were collected and analyzed. We used the R.I.R.S. scoring system to classify the complexity of kidney stones and divided these kidney stones into three subgroups, namely, mild-, moderate-, and severe-complexity group. And then, the effectiveness of stone basket in these subgroups was analyzed.

Results

Although using a stone basket significantly reduced re-operation rate (17.8% in dusting group versus 10.2% in dusting plus basketing group, p = 0.013), no significant difference on stone-free rate (SFR) and overall incidence of complications were noticed between groups. After we classified the complexity of kidney stones using the R.I.R.S. scoring system, we found a stone basket was helpful to improve SFR in kidney stones with moderate-complexity that had been visually dusted in fURL (73.5% in dusting group versus 87.3% in dusting plus basketing group, p = 0.002) but had limited influence on SFR in mild (93.8% in dusting group versus 92.6% in dusting plus basketing group, p = 0.783) or severe (28.5% in dusting group versus 34.0% in dusting plus basketing group, p = 0.598)—complexity kidney stones.

Conclusion

The use of stone basket should be encouraged in moderate-complexity kidney stones which can be visually dusted in fURL.

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Data will not be shared as it contains identifiable patient variables.

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Acknowledgements

The authors appreciate all our participants for their gracious contribution in this study.

Funding

This project was supported by Shanghai Shen Kang Hospital Development Center (Grant No. SHDC12016226), Science and Technology Commission of Shanghai Municipality (Grant No. 19441909400, No. 18411960300), Science and Technology Commission of Songjiang District (Grant No. 18SJKJJJ13), Shanghai Pujiang Program (Grant No. 2020PJD046), and Shanghai Municipal Hospital Urology Specialist Alliance (Grant Nos. SHDC22021314-A, SHDC22021314-B).

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Author notes

  1. Deng Li, Lei Chen, and Xiaolu Lun have contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Road, Hongkou District, Shanghai, 200080, China

    Deng Li, Lei Chen, Chaoliang Xu, Jun Lu, Shujie Xia & Yi Shao

  2. Shanghai Municipal Hospital Urology Specialist Alliance, No. 100, Haining Road, Hongkou District, Shanghai, 200080, China

    Deng Li, Jun Lu, Shujie Xia & Yi Shao

  3. Department of Urology, Weifang Traditional Chinese Hospital, Shandong University of Traditional Chinese Medicine, No. 1055, Weizhou Road, Kuiwen District, Shandong, 261000, China

    Xiaolu Lun, Kai Wang, Xiaolong Wang, Yuhang Bi & Yongchuan Wang

Authors
  1. Deng Li
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  2. Lei Chen
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  3. Xiaolu Lun
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  5. Kai Wang
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  8. Jun Lu
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  10. Yongchuan Wang
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  11. Yi Shao
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Contributions

DL, LC, and XLL contributed equally to this work. DL: manuscript writing and statistical analysis; LC: manuscript editing and data collection; XLL: manuscript editing and data collection; CLX: data collection; KW: data collection; XLW: data collection; YHB: data collection; JL: operation performing; SJX: project development; YCW: operation performing and project development; YS: operation performing and project development.

Corresponding authors

Correspondence to Yongchuan Wang or Yi Shao.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

This is a retrospective study with the approval of the Ethics Review Boards of Weifang Traditional Chinese Hospital and Shanghai General Hospital. All individual participants were informed the possibility of using their clinical parameters for academic purposes and signed informed consent.

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Individual person’s data are not included in the current research and consent for publication is not applicable.

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Li, D., Chen, L., Lun, X. et al. Actively extracting kidney stones combined dusting technique can improve SFR of moderate-complexity kidney stones in fURL. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-03995-w

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  • DOI: https://doi.org/10.1007/s11255-024-03995-w

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