{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T17:36:57Z","timestamp":1777484217085,"version":"3.51.4"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"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":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Percutaneous nephrolithotomy (PCNL) often fails to achieve complete stone clearance with a single procedure. Residual fragments, irrespective of size, are associated with increased stone\u2010related morbidity and a higher likelihood of re\u2010intervention. Endoscopic combined intrarenal surgery (ECIRS), which integrates PCNL with retrograde ureterorenoscopy, may improve stone\u2010free rates and reduce morbidity. However, given the potential for increased risks and greater resource utilisation, a comprehensive randomised controlled trial is warranted. The \u2018PRECISE\u2019 trial is designed to compare ECIRS and PCNL in terms of efficacy, safety, stone\u2010related morbidity, and resource utilisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>The PRECISE is a prospective, non\u2010blinded, randomised, parallel\u2010group, multicentre interventional trial involving patients eligible for percutaneous kidney stone surgery. Patients will be randomised in a 1:1 ratio to undergo either ECIRS or standard PCNL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Endpoints<\/jats:title>\n                    <jats:p>The primary endpoint is the Grade A (0\u2009mm) stone\u2010free rate on postoperative computed tomography (CT) at 4\u2009weeks. Secondary radiological endpoints include Grade B (\u22642\u2009mm) and Grade C (\u22644\u2009mm) stone\u2010free rates at 4\u2009weeks, stone volume reduction, 1\u2010year stone\u2010free rates, and radiation exposure. Additional outcomes include complications, operative duration, stone\u2010related events (SREs), health\u2010related quality of life (HRQoL), cost differences, cost\u2010effectiveness and environmental impact, assessed up to 5\u2009years postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>Adults (aged \u226518\u2009years) eligible for percutaneous kidney stone surgery, where retrograde access is feasible, will be recruited. The main exclusion criteria comprise papillary calcifications, renal transplant procedures, and (suspected) pregnancy. A total of 350 patients (175 per arm) will be recruited. Follow\u2010up includes CT imaging with clinical consultations at 4\u2009weeks and 1\u2009year to evaluate radiological outcomes, complications, SREs, and HRQoL. Telephone interviews at 3 and 5\u2009years will assess long\u2010term SREs and HRQoL. We aim to retrospectively evaluate cost differences, cost\u2010effectiveness, and environmental impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The PRECISE study: an investigation into combined kidney stone surgery, Dutch Trial Registry, NL\u2010009577.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70008","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T12:27:16Z","timestamp":1758803236000},"page":"76-86","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The benefits of\n                    <scp>PCNL<\/scp>\n                    combined with ureterorenoscopy compared to isolated\n                    <scp>PCNL<\/scp>\n                    in urolithiasis (\n                    <scp>PRECISE<\/scp>\n                    ): a multicentre randomised controlled trial protocol"],"prefix":"10.1111","volume":"137","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 Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1648-0419","authenticated-orcid":false,"given":"Riemer A.","family":"Kingma","sequence":"additional","affiliation":[{"name":"Department of Urology, University Medical Center Groningen University of Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Bakker","sequence":"additional","affiliation":[{"name":"Department of Urology Ziekenhuisgroep Twente (Hospital Group Twente)  Almelo The 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M.","family":"van Oort","sequence":"additional","affiliation":[{"name":"Department of Urology, University Medical Center Groningen University of Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4869-7789","authenticated-orcid":false,"given":"Stijn","family":"Roemeling","sequence":"additional","affiliation":[{"name":"Department of Urology, University Medical Center Groningen University of Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the ROUND\u2010PRECISE study 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