PurposeThe miniaturization of instruments has had an impact on stone management. The aims of this study were to highlight surgeon preferences among Retrograde Intra Renal Surgery (RIRS), Regular, Mini-, UltraMini- and Micro- Percutaneous Nephrolithotomy (PCNL) for urolithiasis and to compare the effectiveness and safety of these techniques in a real-life setting.MethodsA 12-item survey regarding endourological techniques was conducted through Survey Monkey among attendees of the 2013 European Association of Urology Section of Urolithiasis meeting. We asked responders to share data from the last 5 cases they performed for each technique. Procedures were stratified according to stone size and the centres’ surgical volume. Techniques were compared in terms of effectiveness and safety. Analyses were performed on the overall group and a subgroup of 1–2 cm stones.ResultsWe collected data from a total of 420 procedures by 30, out of 78, urologists who received the survey (response rate 38%): 140 RIRS, 141 Regular-PCNL (>20 Ch), 67 Mini-PCNL (14–20 Ch), 28 UltraMini-PCNL (11–13 Ch) and 44 Micro-PCNL (4,8–8 Ch). Techniques choice was influenced by stone size and the centre’s surgical volume. Effectiveness and safety outcomes were influenced by stone size, independently of the technique. The stone-free rate was significantly lower in Micro-PCNL compared to Regular-PCNL. This was not confirmed for 1–2 cm stones. All techniques presented a lower complication rate than Regular-PCNL, with Mini-PCNL being the most protective technique compared to Regular-PCNL.ConclusionsStone size seems to drive treatment choice. Miniaturized PCNL techniques are widely employed for 1–2 cm stones, in particular in higher surgical volume centres. Mini-PCNL and RIRS are growing in popularity for stones > 2 cm. Mini-PCNL seems to be a good compromise, being the most effective and safe procedure among PCNL techniques. RIRS is characterized by satisfactory stone-free and low complication rates.
MiNerVa Urologica e Nefrologica 475 precise prognosis and helping in the decision making process for the selection of either adjuvant or salvage therapy.Until nowadays, the indication to perform i n the treatment of prostate cancer (Pca), pelvic lymph node dissection (PlND) represents the most effective method to diagnose lymph node invasion (lNi), allowing a more
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