Abstract
To report our prospective comparison of clinical efficacy between multimodular flexible ureteroscope, PolyScope, and conventional flexible ureteroscope, both combined with holmium laser lithotripsy in managing renal stones<3cm in diameter. Between February 2011 and July 2014, a total of 360 adult patients with renal stones were randomized in a single tertiary-care center trial. For 180 patients in each arm, flexible ureteroscopy and holmium laser lithotripsy were done with either PolyScope or Olympus URF P-5 as control. The primary end points were single-session stone fragmentation rate and stone-free rate. The secondary end points comprised operation time, complication rate, and hospital stay. Demographic and preoperative parameters were comparable between 2 groups. For stones of different locations and sizes, single-session stone fragmentation rate of PolyScope was similar to that of URF P-5. However, for lower calyceal stones, URF P-5 was significantly better than PolyScope (82.0% vs 69.2%; P=.022). No statistically significant difference existed in single-session or overall stone-free rate, complication rate, and hospital stay. Mean operation time of PolyScope group was 92.6±20.2minutes, 9minutes (10.8%) longer than that of URF P-5 group 83.3±17.1minutes (P<.01). PolyScope demonstrates similar overall stone clearance rate to a conventional flexible ureteroscope in managing renal calculi<3cm in diameter, but for lower pole stones, it is of inferior efficacy and it is more skillfully demanding, taking longer operation time.
Published Version
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