Overactive bladder (OAB) is a common urological condition affecting millions of people worldwide, significantly reducing their quality of life. Patient com

To systematically assess the effectiveness and safety of retrograde intrarenal surgery (RIRS) versus percutaneous nephrolithotomy (PCNL) in treating lower pole stones. PubMed, Ovid MEDLINE, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE were researched to identify relevant studies up to May 2018. Based on keyword searches, we explored 1972 studies; following screening and eligibility evaluation, 414 studies were removed for various reasons, including 11 possibly relevant studies for this systematic review. A total of 1342 patient data were interpreted (PCNLn = 688; RIRS n = 654). The stone-free rate (SFR) in ten studies following the PCNL operation varies from 68 to 98.3%, while after the RIRS procedure, it ranges from around 46–93.7%. Out of 10 investigations, 7 demonstrated a superior SFR for the PCNL technique compared to the RIRS. Of the ten investigations, eight demonstrated reduced surgical durations using the PCNL method compared to the RIRS procedure. The duration of hospital stays for the PCNL treatment varies from around 0.3 ± 0.04 to 5.3 ± 1.20 days, while the duration for RIRS procedures ranges from 0 to 3.2 ± 0.52 days. All nine trials indicated a reduced period of hospital stay with the RIRS technique compared to the PCNL procedure. The complication rates in 10 studies following the PCNL surgery varied from approximately 2–72%, while those after the RIRS procedure ranged from about 4–21.6%. Out of 10 trials, 6 demonstrated a reduced complication rate with the RIRS technique compared to the PCNL. The majority of studies in this systematic review indicate that the PCNL method exhibits a superior SFR, reduced operational duration, prolonged hospital stay, and increased complication rates compared to the RIRS procedure. Not applicable, as this is a systematic review.

This study evaluates the impact of chronic kidney disease (CKD) stages on stone-free rates (SFR) and renal function outcomes after percutaneous nephrolithotomy (PCNL). Additionally, it examines the predictive role of the CROES and Guy’s Stone Score (GSS) systems. Data from 2994 patients who underwent PCNL between 2007 and 2024 were retrospectively analyzed. Patients were classified into four CKD groups based on preoperative estimated glomerular filtration rate (eGFR). SFR, complication rates, and postoperative renal function changes were assessed. SFR was significantly lower in advanced CKD stages (p < 0.001), with the lowest in Group A (GFR < 30, 64.1%) and highest in Group D (GFR > 90, 79.1%). Postoperative eGFR increased in CKD stage 4–5 but declined in normal kidney function groups. Complication rates were higher in advanced CKD stages (p = 0.031). CROES and GSS scores correlated with stone complexity and surgical outcomes (p < 0.001). Advanced CKD is associated with lower SFR, greater surgical complexity, and higher complication rates. PCNL remains an effective treatment, particularly in CKD patients, with potential postoperative renal function improvement. Utilizing predictive scoring systems can optimize patient selection and surgical planning. Further prospective studies are needed to validate these findings.

PCNL, a minimally invasive surgical technique for kidney stone removal, relies on achieving stone-free status, which various scoring systems aim to predict. This study assesses the predictive accuracy of the Clinical Research Office of the Endourological Society (CROES) and Guy's Stone Score (GSS) systems in determining stone-free rates following percutaneous nephrolithotomy (PCNL) in pediatric patients. A retrospective analysis was conducted on 580 pediatric patients who underwent PCNL at Çukurova University Urology Clinic between January 2007 and March 2024. Patients were categorized into two groups based on postoperative stone status: Group 1 and Group 2. CROES and GSS scores were calculated for each patient. The association between these scores and stone-free status, as well as postoperative complications, was statistically analyzed. Additionally, subgroup analyses were performed based on age groups. The study showed that 83.7% of patients achieved a stone-free condition postoperatively. Significant differences were found between the stone-free and residual stone groups regarding stone burden and operative time (p < 0.001). CROES had high accuracy for predicting stone-free outcomes (p < 0.001), while GSS was also effective in predicting both stone-free rates and complications. CROES was less effective in predicting complications. Both CROES and GSS are valuable for predicting PCNL outcomes in pediatric patients. While CROES is more reliable for stone-free rates, GSS better predicts complications. However, their limitations highlight the need for pediatric-specific scoring models. Until such models are developed, these systems should be used with caution alongside individualized clinical assessments.