{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T15:18:58Z","timestamp":1773415138511,"version":"3.50.1"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"6","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["URP"],"abstract":"<jats:p>Objective: Fluoroscopy has been the most widely used guidance method for percutaneous nephrolithotomy (PCNL); however, radiation exposure is a significant concern. Recently, ultrasound has gained popularity, offering several advantages. The objective was to evaluate the safety and outcomes of the pure-ultrasound PCNL with a two-step tract dilation.\r\nMaterial and Methods: The authors retrospectively analyzed the data of patients from March 2019 to October 2023. In all patients, percutaneous renal access was ultrasound guided, and they were divided into 2 groups: Group 1, all steps of PCNL were performed under ultrasound guidance, and Group 2, tract dilation, confirmation of stone clearance, and exit strategy were done with fluoroscopy.\r\nResults: The authors included 100 patients, 60 in Group 1 and 40 in Group 2, with a mean body mass index of 30.8 kg\/m2. Mean stone burden was 4,162 mm3, 53% were complex stones and 59% of the cases were without hydronephrosis in the targeted calyx. Fluoroscopy was absent in Group 1 and 20 (11.3-31.5) seconds in Group 2 (P &lt; .001). Complications were present in 13% of the cases. Group 1 patients had a lower complication rate than those in Group 2 (10% and 17%, respectively, P = .27). The authors had a global stone-free rate of 79%, Group 1: 78.3% and Group 2: 80% (P = 1.0). Multivariate analysis revealed that the stone-free rate is associated with the total operative time (P = .002) and the number of tracts (P = .031).\r\nConclusion: Pure ultrasound PCNL is a safe and effective technique, offering a similar stone-free rate compared to fluoroscopy and providing an alternative method to avoid radiation exposure during PCNL.\r\n\u00a0\r\nCite this article as: Pulido-Contreras E, Garcia-Padilla MA, Rios-Melgarejo C, Medrano-Sanchez J, Leon-Verdin MG, Sur RL. Pure ultrasound with two-step dilation vs. combined ultrasoundfluoroscopy in percutaneous nephrolithotomy: Is fluoroscopy still needed? Urol Res Pract. 2025;51(6):217-224.<\/jats:p>","DOI":"10.5152\/tud.2026.25096","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T11:46:46Z","timestamp":1772538406000},"page":"217-224","source":"Crossref","is-referenced-by-count":0,"title":["Pure Ultrasound with Two-Step Dilation vs. Combined Ultrasound-Fluoroscopy in Percutaneous Nephrolithotomy: Is Fluoroscopy Still Needed?"],"prefix":"10.5152","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1069-5996","authenticated-orcid":false,"given":"Enrique","family":"Pulido-Contreras","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5467-0139","authenticated-orcid":false,"given":"Miguel Angel","family":"Garcia-Padilla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9360-8450","authenticated-orcid":false,"given":"Carlos Rios","family":"Melgarejo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6246-6197","authenticated-orcid":false,"given":"Javier","family":"Medrano-Sanchez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5116-6356","authenticated-orcid":false,"given":"Maria Guadalupe","family":"Leon-Verdin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8183-882X","authenticated-orcid":false,"given":"Roger L.","family":"Sur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3111","published-online":{"date-parts":[[2026,3,13]]},"container-title":["Urology Research and Practice"],"original-title":[],"link":[{"URL":"https:\/\/urologyresearchandpractice.org\/index.php\/pub\/article\/download\/3675\/3667","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/urologyresearchandpractice.org\/index.php\/pub\/article\/download\/3675\/3667","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T11:36:04Z","timestamp":1773401764000},"score":1,"resource":{"primary":{"URL":"https:\/\/urologyresearchandpractice.org\/index.php\/pub\/article\/view\/3675"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,13]]},"references-count":0,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3,13]]}},"URL":"https:\/\/doi.org\/10.5152\/tud.2026.25096","relation":{},"ISSN":["2980-1478"],"issn-type":[{"value":"2980-1478","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,13]]}}}