Abstract

PERCUTANEOUS NEPHROLITHOTOMY VERSUS FLEXIBLE URETERORENOSCOPY IN MANAGEMENT OF RENAL STONE (1.5 – 3.0 CM) AT TRIPOLI, LIBYA

Nasr Alfgi*, Aymen Mogadamy and Manani Shaalyia

ABSTRACT

Percutaneous nephrolithotomy (PCNL) is the gold-standard treatment for kidney stones >20 mm, according to the most recent guidelines. Smaller stones may be treated by external shockwave lithotripsy (ESWL) or by flexible ureteroscopy (FURS), despite suboptimal results for stones between 15 and 20 mm. The lack of prospective randomized trials directly comparing flexible ureteroscopy (FURS) and percutaneous nephrolithotomy (PCNL) makes comparison challenging. The numerous studies are not standardized in terms of their definition of stone-free or how stone size is reported. The results from the literature show that moderately large stones from 2 to 3 cm treated ureteroscopically have similar outcomes to Percutaneous nephrolithotomy. “The aim of the study is to compare the efficacy and safety of percutaneous nephrolithotomy (PCNL) and flexible ureteroscopy (FURS) in the treatment of renal stone measuring 1.5 to 3 centimeters”. This retrospective study was conducted in the Libyan swiss center, Masara clinic, Ghout shaal hospital and Ishbilia clinic, Libya with 21 cases each procedure respectively during the study period from January 2023 to December 2024. The male patients are affected 57.14% in flexible ureteroscope and 66.66% in percutaneous nephrolithotomy, while female are affected 42.85% in flexible ureteroscope and 33.33% in percutaneous nephrolithotomy. Age wise categories into 15 to 25, 26 to 50 and greater than 50. The analgesia required in FURS is 66.66% and 71.42% in PCNL. The stone free status in 1st session is 33.33% in FURS and 28.57% in PCNL, 2nd session is 52.38% in FURS and 57.14% in PCNL and 3rd session is 14.28% in FURS and 14.28% in PCNL. Time taken may be varies from 15 to 60 minutes, the time taken from 30 to 60 minutes is 9.52% in FURS and 9.52% in PCNL.

Keywords: Flexible ureteroscopy, Percutaneous nephrolithotomy, Urinary calculi, Libya.