الفهرس 
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Abstract
Objective:Our aim was to evaluate the efficacy and safety of flexible ureteroscopy and laser lithotripsy (FURSL) for lower calyceal stones ≤ 20 mm as compared to extracorporeal shock wave lithotripsy (ESWL).
Patients and methods: The database of our patients with lower calyceal stones ≤ 20mm was reviewed to obtain two matched groups, one treated with flexible ureteroscopy (FURSL) and another with ESWL. Matching parameters were stone length, affected side and patient gender. The stone free rate (SFR) was defined as having no residual fragments evaluated 3 months after the last FURSL or ESWL session by non-contrast CT for all patients. Both groups will be compared for retreatment rate, complication rate, SFR, secondary and total number of procedures and operation duration. Retreatment was defined as the need for a second session of the same primary modality.
Results: Our total study population included 100 patients divided into the two equally numbered treatment groups. Retreatment rate was significantly higher for the ESWL group compared to the FURSL group (60% vs 8%, P < 0.001). Although complications were higher for the FURSL (12% vs 4%), the difference was insignificant ( P = 0.146). The SFR was significantly better for after FURSL (96% vs 58%, P = 0.038). The four failures after FURSL (8%) as well as the five failures (10%) after ESWL were treated by percutaneous nephrolithotripsy (PCNL). Sizable residual fragments were treated in four patients (8%) after FURSL opposed to five (10%) after ESWL whom were cleared with FURSL.
Conclusion: For treatment of lower calyceal calculi ≤20 mm, FURSL achieved a significantly higher stone-free rate and lower retreatment rate compared to ESWL. The incidence of complications after FURSL was insignificantly higher than after ESWL.
Key Words:
Lower renal calyx anatomy , Urolithiasis, Ureteroscopy, Extracorporeal shockwave lithotripsy, Laser Lithotripsy