{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T21:55:45Z","timestamp":1778104545612,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the longer\u2010term impact of intraoperative cone\u2010beam computed tomography (CBCT) on stone\u2010related morbidity after percutaneous nephrolithotomy (PCNL), since intraoperative CBCT allows for the detection and\u00a0removal of residual fragments during the same procedure, improving stone clearance and thereby potentially diminishing stone\u2010related morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>This study was a retrospective analysis of a previously conducted single\u2010centre randomised controlled trial at a tertiary complex endourology centre, in which patients were randomised intraoperatively to PCNL with intraoperative CBCT or conventional PCNL. We analysed 18\u2010month follow\u2010up data to assess differences in stone\u2010related events (SREs), including re\u2010interventions, emergency department visits, and hospital admissions. Stone\u2010free rates and time to stone recurrence, as determined by follow\u2010up CT scans, were also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The CBCT group (<jats:italic>n<\/jats:italic>\u2009=\u200980) had a significantly lower detection rate of new or residual fragments &gt;4\u2009mm (hazard ratio [HR] 0.61, 95% confidence interval [CI] 0.38\u20130.97), with 29 (36%) cases during 18\u2009months of follow\u2010up compared to 40 (50%) cases in the conventional PCNL group (<jats:italic>n<\/jats:italic>\u2009=\u200980). The restricted mean (standard deviation [SD]) time to fragment detection was 420\u2009(44)\u2009days in the CBCT group vs 318\u2009(53)\u2009days in the conventional PCNL group. In the CBCT group, 15 (19%) cases experienced 26 SREs, compared to 23 (29%) cases with 39 SREs in the conventional PCNL group. The restricted mean (SD) time to SRE was 499\u2009(26)\u2009days for CBCT cases, compared to 447\u2009(39)\u2009days for conventional PCNL cases. The rate of SREs did not decrease significantly when comparing CBCT\u2010PCNL to conventional PCNL (HR 0.61, 95% CI 0.32\u20131.17).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study found 10% fewer patients with SREs in the 18\u2010month period after PCNL with intraoperative CBCT compared to conventional PCNL. This difference is likely due to the notable increase in stone\u2010free rates following a single PCNL with intraoperative CBCT.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bju.16859","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T05:24:30Z","timestamp":1752470670000},"page":"848-857","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Longer\u2010term effects of intraoperative cone\u2010beam computed tomography in percutaneous nephrolithotomy: 18\u2010month retrospective randomised controlled trial analysis"],"prefix":"10.1111","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0715-2376","authenticated-orcid":false,"given":"Chris A.","family":"Suijker","sequence":"first","affiliation":[{"name":"Department of Urology University Medical Center Groningen, University of Groningen  Groningen The 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