{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:45:11Z","timestamp":1792597511008,"version":"4.5.0"},"reference-count":27,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,8]],"date-time":"2023-01-08T00:00:00Z","timestamp":1673136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Renal stones are widespread, with a lifetime prevalence of 10% in adults. Flexible ureteroscopy enables urologists to treat lower calyx stones or even complex renal stones through the natural orifice and achieve an acceptable stone-free rate. Hence, we analyzed the effectiveness and safety of FURS versus PCNL in treating renal stones between 20 and 40 mm in diameter. Materials and methods: We retrospectively analyzed 250 consecutive patients with large renal solitary stones (stone burden between 2 and 4 cm) from 1 January 2019 to 31 December 2020. The patients were divided into two groups: group 1 (125 patients), in which the patients were treated by a retrograde flexible ureteroscopic approach, and group 2 (125 patients), in which we used percutaneous nephrolithotomy. Stone characteristics and anatomical data were observed based on the computed tomography (CT) and\/or KUB (Kidney-ureter-Bladder) radiography imaging archive. Results: The mean stone burden was 26.38 \u00b1 4.453 mm in group 1 and 29.44 \u00b1 4.817 mm in group 2. The stone-free rate after the first ureteroscopy was higher for the PNL(percutaneous nephrolithotomy) group (90.4%) than the F-URS group (68%). After two sessions of ureteroscopy, the SFR was 88.8% in the first group, and after three procedures, the SFR rose to 95.2%. The overall complication rate was higher in group 1 than in group 2 (18.4% vs. 16.8%), but without statistical relevance (p &gt; 0.5). Furthermore, we encountered more grade III and IV complications in the PNL group (8.8% vs. 4.8%, p &lt; 0.05). Conclusion: Flexible ureteroscopy proves to be efficient in treating renal stones over 2 cm. However, the patients must be informed that more than one procedure might be necessary to overcome the entire stone burden.<\/jats:p>","DOI":"10.3390\/medicina59010124","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T02:09:39Z","timestamp":1673230179000},"page":"124","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Comparison between Retrograde Flexible Ureteroscopy and Percutaneous Nephrolithotomy for the Treatment of Renal Stones of 2\u20134 cm"],"prefix":"10.3390","volume":"59","author":[{"given":"Cozma","family":"Cosmin","sequence":"first","affiliation":[{"name":"Department of Urology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cSfantul Ioan\u201d Emergency Clinical Hospital, 042122 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragos Adrian","family":"Georgescu","sequence":"additional","affiliation":[{"name":"Department of Urology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cSfantul Ioan\u201d Emergency Clinical Hospital, 042122 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petrisor","family":"Geavlete","sequence":"additional","affiliation":[{"name":"Department of Urology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cSfantul Ioan\u201d Emergency Clinical Hospital, 042122 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6614-2816","authenticated-orcid":false,"given":"Razvan-Ionut","family":"Popescu","sequence":"additional","affiliation":[{"name":"Department of Urology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cSfantul Ioan\u201d Emergency Clinical Hospital, 042122 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan","family":"Geavlete","sequence":"additional","affiliation":[{"name":"Department of Urology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cSfantul Ioan\u201d Emergency Clinical Hospital, 042122 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1590\/s1677-5538.ibju.2018.0510","article-title":"Comparison of retrograde flexible ureteroscopy and percutaneous nephrolithotomy in treating intermediate size renal stones (2\u20133 cm): A meta-analysis and systematic review","volume":"45","author":"Zewu","year":"2019","journal-title":"Int. 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