Do Hounsfield Units have any significance in predicting intra- and postoperative outcomes in retrograde intrarenal surgery using Holmium and Thulium fiber laser? Results from the FLEXible ureteroscopy Outcomes Registry (FLEXOR)

Keat WOL 1 , Somani BK 2 , Pietropaolo A 2 , Chew BH 3 , Chai CA 4 , Inoue T 5 Show all authors , Ragoori D 6 , Biligere S 7 , Galosi AB 8 , Pavia MP 8 , Milanese G 8 , Ahn T 9 , More S 10 , Sarica K 11 , Traxer O 12 , Teoh JY 13 , Gauhar V 7 , Castellani D 14

Affiliations 

  • 1 Department of Urology, Penang General Hospital, Penang, Malaysia
  • 2 Department of Urology, University Hospitals Southampton, NHS Trust, Southampton, UK
  • 3 Department of Urology, University of British Columbia, Vancouver, Canada
  • 4 Department of Surgery, Urology Unit, University Malaya, Kuala Lumpur, Malaysia
  • 5 Department of Urology and Stone Center, Hara Genitourinary Hospital, Kobe City, Hyogo, Japan
  • 6 Department of Urology, Asian Institute of Nephrology and Urology, Irram Manzil Colony, Hyderabad, Telangana, India
  • 7 Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore
  • 8 Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Università Politecnica Delle Marche, Via Conca 71, 60127, Ancona, Italy
  • 9 Department of Urology, Toowoomba Base Hospital, Toowoomba, QLD, Australia
  • 10 Department of Urology, Sarvodaya Hospital and Research Center, Faridabad, India
  • 11 Department of Urology, Biruni University Medical School, Istanbul, Turkey
  • 12 Department of Urology AP-HP, Sorbonne University, Tenon Hospital, Paris, France
  • 13 Department of Surgery, Faculty of Medicine, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China
  • 14 Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Università Politecnica Delle Marche, Via Conca 71, 60127, Ancona, Italy. castellanidaniele@gmail.com
World J Urol, 2023 Nov;41(11):2881-2888.
PMID: 36929407 DOI: 10.1007/s00345-023-04362-7

Abstract

PURPOSE: To evaluate outcomes of flexible ureteroscopy for renal stones by comparing hard versus soft stones based on their attenuation on computed tomography (Hounsfield Units-HU).

METHODS: Patients were divided into two groups according to the type of laser employed [Holmium:YAG (HL) or Thulium fiber laser (TFL)]. Residual fragments (RF) were defined as > 2 mm. Multivariable logistic regression analysis was performed to evaluate factors associated with RF and RF needing further intervention.

RESULTS: 4208 patients from 20 centers were included. In whole series, age, recurrent stones, stone size, lower pole stones (LPS), and multiple stones were predictors of RF at multivariable analysis and LPS and stone size with RF requiring further treatment. HU and TFL were associated with lesser RF and RF requiring an additional treatment. In HU 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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