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Comparison of dusting and fragmentation methods in the flexible ureteroscopic treatment of kidney lower calyx stones

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Abstract

To compare the long-term stone-free status of patients who underwent fragmentation of stones followed by active basketing versus stone dusting and spontaneous passage following flexible ureteroscopic treatment for lower calyceal stones. The dusting or fragmentation methods were randomly assigned to patients who were scheduled to undergo RIRS for only renal lower calyceal stones between February 2019 and May 2022, prospectively. Stone-free rates were determined after 3 months by non-contrast computed tomography and patient demography; preoperative and postoperative follow-up data of both groups were evaluated comparatively. While the fragmentation method was applied in 32 patients, the dusting method was applied in the remaining 31 cases. The two groups did not differ significantly regarding the demographic data and laboratory findings. Mean stone size was similar in both groups of cases. Operation time was significantly longer for fragmentation (93.23 ± 27.20 vs 78.43 ± 30.08, p = 0.045) and evaluation of the success rates after 3 months did show that patients in the dusting group had a higher rate of stone-free status when compared with the other group of cases (65.6 vs 87.1%, p = 0.043). Lastly, postoperative fever rates were not significantly different between the two groups (12.5 vs 9.7%, p = 0.518). Our findings showed that dusting the lower calyceal stones during fURS would reveal higher stone-free rates during long-term follow-up periods, and the mean operation time will be shorter in these patients.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Funding

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Authors and Affiliations

  1. Medical School, Department of Urology, Kafkas University, Şehitler mah, 36100, Merkez/Kars, Turkey

    Ümit Yildirim, Mehmet Ezer & Mehmet Uslu

  2. Department of Urology, Medistate Kavacık Hospital, Istanbul, Turkey

    Rasim Güzel

  3. Medical School, Department of Urology, Biruni University, Istanbul, Turkey

    Kemal Sarica

Authors
  1. Ümit Yildirim
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  2. Mehmet Ezer
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  3. Mehmet Uslu
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  4. Rasim Güzel
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  5. Kemal Sarica
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Contributions

Research conception and design: ÜY, KS. Data acquisition: ÜY, ME, MU. Statistical analysis: ÜY, MU. Data analysis and interpretation: RG, KS. Drafting of the manuscript: ÜY, ME, MU, RG, KS. Critical revision of the manuscript: ÜY, KS. Supervision: KS.

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Correspondence to Ümit Yildirim.

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IRB approved our study (80576354–050-99/113). All ethical rules in the Declaration of Helsinki were complied with.

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Yildirim, Ü., Ezer, M., Uslu, M. et al. Comparison of dusting and fragmentation methods in the flexible ureteroscopic treatment of kidney lower calyx stones. Urolithiasis 51, 21 (2023). https://doi.org/10.1007/s00240-022-01399-y

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