Flexible ureterorenoscopy with holmium laser lithotripsy for ureteral calculi complicated by hydronephrosis

To clarify the effects of flexible ureterorenoscopy (FURS) combined with holmium laser lithotripsy on surgical outcomes, postoperative pain (POP), and renal function (RF) for the treatment of ureteral calculi (UC) complicated by hydronephrosis (HN).

A total of 128 patients diagnosed with UC complicated with HN treated between February 2024 and December 2025 were enrolled in this retrospective study and divided according to surgical approach. Among them, 65 patients underwent FURS combined with holmium laser lithotripsy (FURS group), and 63 patients received conventional ureteroscopy (URS) combined with laser lithotripsy (URS group). The two groups were compared in terms of clinical efficacy, surgical metrics (intraoperative blood loss, operative time, one-time stone clearance success rate), hospitalization indicators (hospitalization duration and medical expenses), POP, renal function, routine urine test results, serum inflammatory markers, and postoperative complications.

The FURS group exhibited a significantly higher overall treatment efficacy rate (P=0.035). Additionally, the FURS group had less intraoperative blood loss, a shorter operative time, and a shorter hospital stay (all P<0.001). In terms of postoperative recovery, patients in the FURS group experienced milder pain on postoperative days 1 (P=0.032) and 3 (P<0.001), with better preserved postoperative renal function (P<0.05), improved routine urine test indicators (P<0.05), lower serum inflammatory levels (P<0.05), and fewer total complications (P<0.001). No significant differences were observed between the two groups in the one-time stone clearance success rate and hospitalization expenses (all P>0.05).

FURS demonstrated significantly superior clinical efficacy to conventional URS for the treatment of UC complicated by HN, with better surgical outcome and more safety.