{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T09:24:07Z","timestamp":1792315447636,"version":"4.4.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically review and meta\u2010analyse the available evidence comparing perioperative outcomes between small\u2010 (\u22646.3\/7.5\u2009F) and large\u2010calibre (\u22657.5\/9.8\u2009F) ureteroscopes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search of MEDLINE\/PubMed, and Scopus was performed prior to March 2026 according to Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses (PRISMA) guidelines. The endpoints of interest were stone\u2010free rates (SFRs), overall complications, and operative time. Study quality and risk of bias were evaluated using the Newcastle\u2013Ottawa Scale\u00a0and the Revised Cochrane Risk of Bias Tool for Randomised Trials for non\u2010randomised and randomised studies. Sensitivity analyses were completed on studies reporting flexible ureteroscopes only, 7.5\u2010 vs &gt;7.5\u2010F ureteroscopes, and on randomised controlled trials (RCTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight studies were included in the meta\u2010analysis. Of those, four were RCTs while four were retrospective. Specifically, three studies compared 6.3\u2010 vs 7.5\u2010F ureteroscopes, one 6.3\u2010 vs 8.5\u2010F ureteroscopes, one 6\u2010 vs 7.5\u2010F ureteroscopes, while three compared 7.5\u2010 vs &gt;7.5\u2010F ureteroscopes. Within the meta\u2010analysis comparing 6.3\u2010 vs 7.5\u2010F ureteroscopes, the small\u2010calibre ureteroscopes were associated with a risk ratio [RR] for SFR of 0.99 (95% confidence interval [CI] 0.92\u20131.06), of 1.08 (95% CI 0.77\u20131.51) for overall complications, and a standardised mean difference in operative time of \u221214.5\u2009min (95% CI \u221233.4 to 3.3\u2009min). These results were virtually confirmed by all sensitivity analyses. No differences in the above outcomes were recorded for the comparison between 7.5\u2010 vs &gt;7.5\u2010F ureteroscopes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Within the present meta\u2010analysis, the small\u2010calibre ureteroscopes achieved comparable outcomes to large\u2010calibre ureteroscopes. To overcome the substantial heterogeneity and residual confounding across studies, well\u2010designed and adequately powered RCTs are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70394","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T23:45:18Z","timestamp":1785282318000},"page":"769-776","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Small\u2010 and large\u2010calibre ureteroscopes: an updated systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8585-3701","authenticated-orcid":false,"given":"Francesco","family":"Di Bello","sequence":"first","affiliation":[{"name":"Stone Unit, Department of Urology Fundaci\u00f3 Puigvert, Autonoma University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3662-6828","authenticated-orcid":false,"given":"Paolo","family":"Verri","sequence":"additional","affiliation":[{"name":"Stone Unit, Department of Urology Fundaci\u00f3 Puigvert, Autonoma University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Bravo\u2010Balado","sequence":"additional","affiliation":[{"name":"Stone Unit, Department of Urology Fundaci\u00f3 Puigvert, Autonoma University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9214-6999","authenticated-orcid":false,"given":"Paula","family":"Izquierdo","sequence":"additional","affiliation":[{"name":"Stone Unit, Department of Urology Fundaci\u00f3 Puigvert, Autonoma University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5440-1917","authenticated-orcid":false,"given":"Lucio","family":"Fila","sequence":"additional","affiliation":[{"name":"Stone Unit, Department of Urology Fundaci\u00f3 Puigvert, Autonoma University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres K.","family":"Kanashiro","sequence":"additional","affiliation":[{"name":"Stone Unit, Department of Urology Fundaci\u00f3 Puigvert, Autonoma University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rozalba","family":"Gogaj","sequence":"additional","affiliation":[{"name":"Department of Urology NYU Grossman School of Medicine, NYU Langone Health  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Wells","sequence":"additional","affiliation":[{"name":"Department of Urology NYU Grossman School of Medicine, NYU Langone Health  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Traxer","sequence":"additional","affiliation":[{"name":"Groupe de Recherche Clinique sur la Lithiase Urinaire, GRC N\u00b020, H\u00f4pital Tenon Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oriol","family":"Angerri","sequence":"additional","affiliation":[{"name":"Stone Unit, Department of Urology Fundaci\u00f3 Puigvert, Autonoma University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban","family":"Emiliani","sequence":"additional","affiliation":[{"name":"Department of Urology NYU Grossman School of Medicine, NYU Langone Health  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"EAU Guidelines on Urolithiasis \u2013 INTRODUCTION \u2013 Uroweb. 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