Clinical Efficacy Evaluation of a Novel Negative Pressure Ureteroscopic Lithotripsy for Ureteral Stones.

ABSTRACT

OBJECTIVE: To evaluate the clinical efficacy of a novel negative pressure ureteroscopic lithotripsy (NP-URL) compared to standard ureteroscopic lithotripsy (S-URL) for treating ureteral stones. METHODS: A total of 284 patients diagnosed with ureteral stones and who underwent ureteroscopic lithotripsy between December 2020 and May 2022 at our hospital were included in the study. Among them, 146 cases underwent NP-URL and 138 cases underwent S-URL. The negative pressure device used in NP-URL consists of a 5F ureteric catheter and a tee joint. We evaluated the operative duration, stone-free rate, incidence of postoperative complications, stone retropulsion rate, and adjunct procedure rate between the two groups. RESULTS: The mean operative duration was significantly shorter in the NP-URL group compared to the S-URL group (30.17 ± 5.84 minutes vs 34.84 ± 6.62 minutes; P＜.05). Additionally, the NP-URL group had a lower incidence of postoperative fever (1.4% vs 8.7%; P＜.05), reduced stone retropulsion rate (3.4% vs 11.6%; P＜.05), and a statistically lower rate of adjunct procedures (5.5% vs 14.5%, P＜.05). The NP-URL group also demonstrated a higher primary stone-free rate (91.8% vs 81.9%; P＜.05). However, there was no significant difference in the final stone-free rate between the NP-URL and S-URL groups (P＞.05). CONCLUSION: NP-URL potentially reduces operative duration, significantly decreases the incidence of postoperative complications, and achieves better primary stone-free rates compared to S-URL.