Back to Journals » Reports in Medical Imaging » Volume 6

Flexible ureteroscopy versus percutaneous nephrolithotomy as primary treatment for renal stones 2 cm or greater

Authors Akar E, Knudsen B

Received 26 August 2012

Accepted for publication 11 December 2012

Published 16 January 2013 Volume 2013:6 Pages 1—10

DOI https://doi.org/10.2147/RMI.S28852

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3


Erin Akar, Bodo E Knudsen

Department of Urology, Ohio State University Wexner Medical Center, Columbus, OH, USA

Abstract: The purpose of this review, based on the current evidence in the literature, is whether ureteroscopy (URS) is a comparable primary treatment option to the current gold standard of percutaneous nephrolithotomy (PCNL) for the treatment of large kidney stones 2 cm or greater. The lack of prospective randomized trials directly comparing URS and PCNL makes comparison challenging. The numerous studies are not standardized in terms of their definition of stone-free or how stone size is reported. In order to standardize comparison of results, we used a stone-free definition of <4 mm after one procedure per imaging of the author’s choice, since how each patient was imaged postoperatively was not reported. The results from the literature show that moderately large stones from 2 to 3 cm treated ureteroscopically have similar outcomes to PCNL. Stone-free rates with URS decrease when stone size is above 3 cm. Our interpretation of the literature suggests that a current limitation of URS is that multiple procedures for URS would be required to achieve comparable stone-free rates to PCNL, particularly for stones greater than 4 cm.

Keywords: ureteroscopy, percutaneous nephrolithotomy, lithotripsy, urinary calculi

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]