To compare the effectiveness and safety of flexible ureteroscopy with lithotripsy using suction technology (FURL) and miniaturized percutaneous nephrolithotomy (mini-PCNL) for treating 2 to 3 cm renal stones.
Key Findings:
Immediate stone-free rates were 84% for FURL and 85% for mini-PCNL.
At 3 months, stone-free rates were 90% for FURL and 92% for mini-PCNL.
Suction-assisted FURL showed lower intrarenal pressure, shorter hospital stays, and less postoperative pain compared to mini-PCNL.
FURL improved quality of life for patients and had favorable safety profiles in pediatric and complex cases.
Interpretation:
Suction-assisted FURL offers comparable stone-free outcomes to mini-PCNL for 2 to 3 cm stones, with additional benefits in terms of patient recovery and safety.
Limitations:
Some studies suggested mini-PCNL may have an advantage in immediate stone-free rates.
Further multicenter, large-scale trials are needed to clarify the role of FURL in larger stones.
Conclusion:
Treatment selection should be individualized based on stone characteristics, patient factors, and available expertise, with suction-assisted FURL emerging as a viable option for moderate stone burdens.
