title: Comparing the Efficacy of a Multimodular Flexible Ureteroscope With Its Conventional Counterpart in the Management of Renal Stones.
abstract: OBJECTIVE
  To report our prospective comparison of clinical efficacy between multimodular flexible ureteroscope, PolyScope, and conventional flexible ureteroscope, both combined with holmium laser lithotripsy in managing renal stones <3 cm in diameter.
  
  
  METHODS
  Between February 2011 and July 2014, a total of 360 adult patients with renal stones were randomized in a single tertiary-care center trial. For 180 patients in each arm, flexible ureteroscopy and holmium laser lithotripsy were done with either PolyScope or Olympus URF P-5 as control. The primary end points were single-session stone fragmentation rate and stone-free rate. The secondary end points comprised operation time, complication rate, and hospital stay.
  
  
  RESULTS
  Demographic and preoperative parameters were comparable between 2 groups. For stones of different locations and sizes, single-session stone fragmentation rate of PolyScope was similar to that of URF P-5. However, for lower calyceal stones, URF P-5 was significantly better than PolyScope (82.0% vs 69.2%; P = .022). No statistically significant difference existed in single-session or overall stone-free rate, complication rate, and hospital stay. Mean operation time of PolyScope group was 92.6 ± 20.2 minutes, 9 minutes (10.8%) longer than that of URF P-5 group 83.3 ± 17.1 minutes (P < .01).
  
  
  CONCLUSIONS
  PolyScope demonstrates similar overall stone clearance rate to a conventional flexible ureteroscope in managing renal calculi <3 cm in diameter, but for lower pole stones, it is of inferior efficacy and it is more skillfully demanding, taking longer operation time.
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Ding
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Ding
authors.initials: D
authors.lastname: Xu
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Qifeng
authors.initials: Q
authors.lastname: Cao
authors.affiliation: Department of Urology, Anhui Provincial Hospital, Hefei, Anhui, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Huang
authors.affiliation: Department of Ultrasonography, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yunkai
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Anesthesiology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Huang
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yifan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Chengcai
authors.initials: C
authors.lastname: Liang
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Qi
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: xiaoding@sjtu.edu.cn.
authors.forename: Yunteng
authors.initials: Y
authors.lastname: Huang
mesh_terms: D004867:Equipment Design; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D053844:Lasers, Solid-State / Q000009:adverse effects / Q000627:therapeutic use*; D007902:Length of Stay; D017602:Lithotripsy, Laser / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D016896:Treatment Outcome; D020709:Ureteroscopes