title: Flexible ureteroscopy with holmium laser lithotripsy: a new choice for intrarenal stone patients.
abstract: OBJECTIVE
  To evaluate the efficiency and safety of flexible ureteroscopy (FURS) and holmium lithotripsy for intrarenal stones and to stratify the efficiency and safety by stone burdens of ≤20, 20-40, and ≥40 mm.
  
  
  METHODS
  Five hundred eighty-two patients with intrarenal stones were treated with FURS and holmium lithotripsy at a single department from August 2008 to October 2013. Stone size was evaluated by calculating the cumulative stone diameter of all intrarenal stones, and stone-free status was defined as the absence of any stone or stone fragment <1 mm in the kidney.
  
  
  RESULTS
  Data analysis revealed a mean stone burden of 21.8 ± 7.6 mm. The overall primary stone-free rate (SFR) was 65.3%, which increased to 89.0% 6 months after the first surgery. Complications developed in 6.7% of patients. A significant difference was found between lower-calyx stones and other stones (p < 0.001; p = 0.006), while noncalcium stones had a much higher SFR than calcium stones (p < 0.001; p = 0.04).
  
  
  CONCLUSIONS
  Our study showed that the overall renal SFR with the use of FURS and holmium lithotripsy was satisfactory, with a relatively low complication rate. We believe that FURS with holmium lithotripsy could be a valuable choice for patients with renal stones, especially for patients with a cumulative stone burden ≤40 mm.
authors: Department of Urology, First People's Hospital of Wujiang City, Suzhou, PR China.
authors: Chen
authors: C
authors: Xu
authors: Ri-jin
authors: RJ
authors: Song
authors: Min-jun
authors: MJ
authors: Jiang
authors: Chao
authors: C
authors: Qin
authors: Xiao-lan
authors: XL
authors: Wang
authors: Wei
authors: W
authors: Zhang
mesh_terms: D000328:Adult; D004867:Equipment Design; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000175:diagnosis / Q000601:surgery*; D053844:Lasers, Solid-State / Q000009:adverse effects / Q000627:therapeutic use*; D017602:Lithotripsy, Laser / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012074:Remission Induction; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D020709:Ureteroscopes; D018666:Ureteroscopy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods