Effect of flexible cystoscopy combined with flexible ureteroscopy on short-term outcomes in patients with complex renal stones.

OBJECTIVE

To investigate the short-term efficacy of combining flexible cystoscopy with flexible ureteroscopy in the treatment of complex renal stones.

METHODS

The medical records of 145 patients with complex renal stones admitted to Yan'an People's Hospital from February 2020 to February 2022 were retrospectively analyzed. Among these, 65 patients treated with flexible ureteroscopy alone constituted the control group. The research group consisted of 81 patients receiving both flexible cystoscopy and flexible ureteroscopy. Outcomes compared between the two groups included stone removal rate, operative time, time to ambulation, hospitalization duration, and intraoperative bleeding. Logistic regression analysis was used to assess the risk of stone retention.

RESULTS

In the research group, the stone removal rate was 85.19% and the residual stone rate was 14.81%, compared to a stone removal rate of 70.77% and a residual rate of 29.23% in the control group, with a statistically significant difference (P<0.05). The research group had a significantly longer operative time than the control group (P<0.05). However, intraoperative bleeding and hospitalization duration were significantly lower in the research group (P<0.05). There was no statistically significant difference in time to ambulation between the groups (P>0.05). Multivariate logistic regression analysis identified multiple stones (OR=3.581, P=0.013) as an independent risk factor for residual stones, while stone location outside the lower calyx (OR=0.305, P=0.021) and treatment with combined flexible cystoscopy and ureteroscopy (OR=0.398, P=0.160) were independent protective factors against residual stones. The area under the curve for predicting stone retention based on the number of stones, stone location, and treatment modality were 0.647, 0.642, and 0.606, respectively.

CONCLUSION

The combination of flexible cystoscopy and flexible ureteroscopy in treating patients with complex renal stones significantly improves the stone clearance rate and postoperative patient recovery.