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The aim of our study was to compare the effectiveness and safety of standard PCNL (S-PCNL) and RIRS for the treatment of stones at ureteropelvic junction with high-grade hydronephrosis. The study included 118 patients who underwent surgery for stones at ureteropelvic junction. S-PCNL and RIRS were performed on 66 and 52 patients, respectively. Patient age, sex, body mass index (BMI), stone side, history of urinary tract infection (UTI), history of diabetes, history of ESWL, stone size, Hounsfield unit (HU) values of stones, grade of hydronephrosis, operating time, postoperative hemoglobin loss, narcotic analgesic use, postoperative transfusion rates, stone-free rates (SFRs), length of hospital stay, complication rates and number of secondary interventions were recorded. The comparison of the operative data between the two groups revealed no statistically significant differences in the operative time, SFRs, narcotic analgesic use, postoperative transfusion rate or other postoperative complications defined according to the Clavien system (P\u2009&gt;\u20090.05). The postoperative urinary sepsis rate in the RIRS group was as high as 15.4%, which was much higher than the 1.5% rate observed in the S-PCNL group, and the difference was statistically significant (P\u2009&lt;\u20090.05). A total of 13.5% of the patients in the RIRS group required a second operation due to failure of the placement of the ureteral access sheath. Additionally, S-PCNL had an advantage in operation time, while RIRS in duration of hospital stay and postoperative hemoglobin loss. RIRS and S-PCNL were safe and effective methods for the treatment of stones at ureteropelvic junction with high-grade hydronephrosis. Importantly, S-PCNL had more advantages in terms of the postoperative urinary sepsis rate and secondary surgery rate.<\/jats:p>","DOI":"10.1038\/s41598-021-93551-8","type":"journal-article","created":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T10:04:51Z","timestamp":1625652291000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Comparison of retrograde intrarenal surgery and standard percutaneous nephrolithotomy for management of stones at ureteropelvic junction with high-grade hydronephrosis"],"prefix":"10.1038","volume":"11","author":[{"given":"Fang","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zesong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liefu","family":"Ye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,7,7]]},"reference":[{"key":"93551_CR1","doi-asserted-by":"publisher","first-page":"9841","DOI":"10.1073\/pnas.0709652105","volume":"105","author":"TH Brikowski","year":"2008","unstructured":"Brikowski, T. H., Lotan, Y. & Pearle, M. S. Climate-related increase in the prevalence of urolithiasis in the United States. Proc. Natl. Acad. Sci. U S A. 105, 9841\u20139846 (2008).","journal-title":"Proc. Natl. Acad. Sci. U S A."},{"key":"93551_CR2","first-page":"e86","volume":"12","author":"V Romero","year":"2010","unstructured":"Romero, V., Akpinar, H. & Assimos, D. G. Kidney stones: A global picture of prevalence, incidence, and associated risk factors. Rev. Urol. 12, e86-96 (2010).","journal-title":"Rev. Urol."},{"key":"93551_CR3","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/j.eururo.2012.03.052","volume":"62","author":"CD Scales Jr","year":"2012","unstructured":"Scales, C. D. Jr., Smith, A. C., Hanley, J. M. & Saigal, C. S. Prevalence of kidney stones in the United States. Eur. Urol. 62, 160\u2013165 (2012).","journal-title":"Eur. 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Oncol. 48, 1022\u20131027 (2018).","journal-title":"Jpn. J. Clin. Oncol."},{"key":"93551_CR9","first-page":"232","volume":"16","author":"AN Karakoyunlu","year":"2019","unstructured":"Karakoyunlu, A. N. et al. Comparison of retrograde intrarenal surgery and percutaneous nephrolithotomy methods for management of big- sized kidney stones(? 4 cm): Single center retrospective study. Urol. J. 16, 232\u2013235 (2019).","journal-title":"Urol. J."},{"key":"93551_CR10","first-page":"326","volume":"16","author":"F Yanaral","year":"2019","unstructured":"Yanaral, F. et al. Comparison of flexible ureterorenoscopy and mini percutaneous nephrolithotomy in the management of multiple renal calculi in 10\u201330 mm size. Urol. J. 16, 326\u2013330 (2019).","journal-title":"Urol. J."},{"key":"93551_CR11","doi-asserted-by":"crossref","unstructured":"Doizi, S., Uzan, A., Keller, E.X., De Coninck, V., Kamkoum, H., Barghouth, Y. et al. 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