Active migration technique in RIRS for 1- to 2-cm middle and upper ureteral stones in a prospective randomized...

Area of Science:

• Urology
• Minimally Invasive Surgery
• Nephrolithiasis Management

Background:

• Ureteral stones pose a significant clinical challenge.
• Retrograde intrarenal surgery (RIRS) is a common treatment modality.
• Optimizing RIRS techniques for stone clearance and safety is crucial.

Purpose of the Study:

• To compare the efficacy and safety of active migration technique versus in situ lithotripsy in RIRS.
• To evaluate outcomes for 1- to 2-cm middle and upper ureteral stones.
• To assess stone-free rates, operative time, and complication incidence.

Main Methods:

• A prospective study involving 207 patients with ureteral stones.
• Study group (103 patients): Active migration lithotripsy with FANS.
• Control group (104 patients): In situ lithotripsy.

Main Results:

• Active migration technique showed significantly shorter operative times (p<0.001).
• Higher immediate (81.5% vs 64.4%) and total (90.3% vs 77.9%) stone-free rates were observed (p<0.015).
• Lower incidence of ureteral stricture (1.0% vs 6.7%) and overall complications (p<0.001) in the study group.

Conclusions:

• Active migration technique with FANS in RIRS is superior to in situ lithotripsy for 1-2 cm ureteral stones.
• This technique improves stone clearance and reduces postoperative complications.
• The findings support the adoption of active migration technique for enhanced RIRS outcomes.