Effectiveness and safety profiles of percutaneous nephrolithotomy and ureteroscopic lithotripsy for proximal ureteral calculi.

OBJECTIVE

To compare the effectiveness and safety of percutaneous nephrolithotripsy (PCNL) and ureteroscopic lithotripsy (URSL) in treating proximal ureteral stones.

METHODS

The clinical data of 86 patients with proximal ureteral stones, admitted to the Department of Urology at the First People's Hospital of Chun'an County from May 2021 to May 2023, were retrospectively analyzed. Patients were divided into a PCNL group (n=41) and a URSL group (n=45) based on the treatment modality. Key outcomes compared between the two groups included surgical time, intraoperative blood loss, incidence of complications, hospital stay, stone clearance rate, lithotripsy success rate, renal function indicators, and levels of inflammatory factors.

RESULTS

The PCNL group had significantly higher intraoperative blood loss and longer postoperative hospital stay compared with the URSL group, whereas the operative time was remarkably shorter (<0.05). The stone clearance and lithotripsy success rates were considerably higher in the PCNL group than in the URSL group, and the complication rates were significantly lower (<0.05). After treatment, the levels of renal function indicators, including serum creatinine (Scr), blood urea nitrogen (BUN), and cystatin C (CysC), decreased significantly in both groups, with the PCNL group showing more pronounced decrease compared to the URSL group (<0.05), approaching normal levels. Additionally, while the levels of procalcitonin (PCT), interleukin-13 (IL-13), and high-sensitivity C-reactive protein (hs-CRP) were elevated in both groups after treatment, the PCNL group showed significantly lower levels of these inflammatory markers compared to the URSL group (all <0.05).

CONCLUSION

Both PCNL and URSL are effective treatments for proximal ureteral stones. However, PCNL offers superior clinical effectiveness and safety.