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Purpose: This study aims to comparatively evaluate clinical outcomes of mini-PCNL and FURS for treating urinary tract calculi in a single session., Methods: A systematic search using electronic databases was performed for studies comparing mini-PCNL and FURS for the treatment of urinary tract calculi. The primary outcome measurements were stone-free rates (SFRs) and complication rates for both techniques. Secondary outcome measurements were to compare patient demographics, operative duration, and inpatient stay. Meta-analysis was performed with Review Manager version 5.3 software., Results: Sixteen studies on 1598 patients (n = 877 for mini-PCNL and n = 721 for FURS) met inclusion criteria. Demographics including age (p = 0.26), body mass index (BMI) (p = 0.51), and gender ratio (p = 0.6), were similar in both groups. Overall, SFR was significantly greater in the mini-PCNL group compared to the FURS group (n = 763/877, 89.3 ± 8.4% versus n = 559/721, 80.1 ± 13.3% [OR 2.01; 95% CI 1.53-2.64; p < 0.01]). Duration of inpatient stay was significantly greater in the mini-PCNL group compared to the FURS group (n = 877, 4 ± 1.6 days versus n = 721, 2.5 ± 2.2 days, respectively [WMD: 1.77; 95% CI 1.16-2.38, p < 0.01]. Overall complication rates were not significantly different between mini-PCNL and FURS (n = 171/877, 19.5 ± 19.1% versus n = 112/721, 15.5 ± 18.9%, respectively [OR 1.43; 95% CI 0.85-2.4, p = 0.18])., Conclusions: Mini-PCNL is associated with greater SFRs and longer inpatient stay compared to FURS. Complication rates were similar for both techniques. The advantages and disadvantages of both technologies should be familiar to urologists and conveyed to patients prior to urological intervention for nephrolithiasis.

Purpose: Data assessing the effectiveness of single-use flexible ureteropyeloscopy (FURS) are limited. This study evaluates and compares single-use FURS with conventional reusable FURS., Methods: A systematic search using electronic databases (Pubmed and Embase) was performed for studies evaluating single-use FURS in the setting of urinary tract stone disease. Outcome measures included a comparative evaluation of their mechanical, optical and clinical outcomes., Results: Eleven studies on 466 patients met inclusion criteria. In vitro comparative data were available on three single-use flexible ureteropyeloscopes (LithoVue™, Polyscope™ and SemiFlex™) and clinical data were available on two (LithoVue™ and Polyscope™). The overall stone-free rate and complication rate associated with single-use FURS was 87 ± 15% and 9.3 ± 9%, respectively. There were no significant differences in procedure duration, stone size, stone clearance and complication rates when single-use FURS and reusable FURS were compared (duration: 73 ± 27 versus 74 ± 13 min, p = 0.99; stone size: 1.36 ± 0.2 versus 1.34 ± 0.18 cm, p = 0.93; stone-free rate: 77.8 ± 18 versus 68.5 ± 33%, p = 0.76; complication rate 15.3 ± 10.6 versus 15 ± 1.6%, p = 0.3)., Conclusions: Single-use FURS demonstrates comparable efficacy with reusable FURS in treating renal calculi. Further studies on clinical efficacy and cost are needed to determine whether single-use FURS will reliably replace its reusable counterpart.