Displacement of Lower Pole Stones During Retrograde Intrarenal Surgery Improves Stone-free Status: A Prospective Randomized Controlled Trial

Editorial Comment

“…In this randomized trial the authors compare in situ laser lithotripsy vs displacement (DIS) during retrograde intrarenal surgery for LP stones. 2 SFR significantly favored the DIS group over the in situ group, with no difference in complication rates and no impact on cost. While stone displacement may not be possible in all cases, the authors make a strong case of using the DIS technique for LP stones whenever possible.…”

This Month in Adult Urology

“…Yaghoubian et al (page 963), in this prospective randomized trial from New York, compare the efficacy of laser lithotripsy for stones in situ compared to displacement out of the lower pole. 4 Stone-free rates were much better with basket displacement, highlighting that this simple technical modification should be considered for those with lower pole stones.…”

Relocation of lower pole renal stones helps improve the stone-free rate during flexible ureteroscopy with a low complication rate

“…With improved technology, flexible ureteroscopy has become an attractive alternative for many urologists in the management of 10–20 mm LPS. Some researchers have recommended FURS for LPS due to its high success and low complication rates [ 1 , 8 – 10 ]. However, the sharp infundibular–pelvic angle (IPA) resulted in the decreased SFR of FURS in LPS compared to upper or middle calyx stones.…”

“…However, the sharp infundibular–pelvic angle (IPA) resulted in the decreased SFR of FURS in LPS compared to upper or middle calyx stones. Therefore, several surgeons recommend relocating the LPS to a favorable calyx before lithotripsy to improve the SFR [ 1 , 8 , 11 ]. However, Shrestha et al reported relocation of LPS followed by laser lithotripsy achieved similar SFR as in situ lithotripsy [ 12 ].…”