Applications of flexible ureteroscope lithotripsy with negative pressure suction and percutaneous nephrolithotomy in the treatment of 2–3 cm diameter renal calculi

Renal calculus, or kidney stone disease, presents a significant healthcare challenge globally, necessitating diverse therapeutic interventions. Percutaneous nephrolithotomy (PCNL) and flexible ureteroscope lithotripsy (FURL) are prominent among these interventions, with PCNL favored for stones > 2 cm and FURL for smaller stones and applications of flexible ureteroscope lithotripsy with negative pressure suction for stones 1.5–2.5 cm have some benefit.

From June 2019 to January 2024, 310 patients undergoing FURL with negative pressure suction or PCNL for 2–3 cm renal calculi were retrospectively analyzed. The demographic and clinical data were collected, and outcomes including stone-free rates (SFR), postoperative complications, and surgical parameters were compared.

Comparable SFR were observed between FURL and PCNL groups at 1-month follow-up, although PCNL was superior to FURL after immediately post-surgery. FURL exhibited significantly fewer complications overall (5.7% vs. 19.3%, p = 0.044), shorter hospital stays, and lower postoperative pain levels. The surgical parameters favored FURL, showing lower bleeding volumes, shorter catheter removal times, and less hemoglobin decrease postoperatively.

Despite similar stone clearance efficacy at 1-month follow-up, FURL demonstrated superior safety and postoperative outcomes compared to PCNL for 2–3 cm renal calculi. These findings highlight the potential advantages of FURL in reducing complications, enhancing recovery, and optimizing patient care pathways.