PURPOSE - This is a prospective multicentric comparative study evaluating the performance of XenX-a new dual-purpose device for the prevention of stone fragments migration during ureteroscopic lithotripsy (URS).
METHODS - Between March 2014 and January 2015, 41 patients undertaking URS + XenX were matched with 41 patients undergoing standard URS. Patients included had unilateral ureteric stone(s) of 0.5-1.5 cm in maximum size. Demographics, complication rates and surgical outcomes were recorded for comparison. A Likert-like 5-grade scoring system was used for surgeons' evaluation of XenX properties. Cost analysis was performed by comparing weighted mean costs of the relevant procedures.
RESULTS - Patients' characteristics between the two groups were comparable. Lasering time was longer for XenX group (13.59 vs. 5.17 min; p = 0.0001) whilst use of basket and need of JJ stent insertion was more frequent in control group (19.5 vs. 97.6 %; p = 0.0001 and 22 vs. 35 %; p = 0.001, respectively). Intra-operative SFR was significantly higher for XenX group (100 vs. 85.4 %; p = 0.0001), but not at 4-week follow-up, after ancillary procedures were needed in 17.1 % of the control group. Surgeons' evaluations for XenX were suboptimal for "Ease of Basketing" (2/5) and "Advancement of double J stent" (3/5). The use of XenX increased costs of procedures, but spared the costs associated to ancillary procedures and stent removals.
CONCLUSIONS - XenX confirmed to be a safe and effective device especially for the treatment of upper ureteric tract stones; moreover, XenX may reduce the risk for the need of auxiliary procedures and for the insertion of a JJ stent.
World journal of urology. 2016 Mar 18 [Epub ahead of print]
Francesco Sanguedolce, Emanuele Montanari, Mario Alvarez-Maestro, Nicola Macchione, Stephan Hruby, Athanasios Papatsoris, Panagiotis Kallidonis, Luca Villa, Patrick Honeck, Olivier Traxer, Francesco Greco, EAU Young Academic Urologists- Endourology and Urolithiasis Working Group
King's College Hospital, NHS Foundation Trust, London, UK. San Paolo Hospital, University of Milano, Milan, Italy., Infanta Sofia University Hospital, Madrid, Spain., San Paolo Hospital, University of Milano, Milan, Italy., Paracelsus Medical University Salzburg, Salzburg, Austria., Sismanoglio General Hospital, Athens, Greece., Patras University Hospital, Patras, Greece., Tenon University Hospital, Paris, France., Sindelfingen-Böblingen Clinic, Boblingen, Germany., Patras University Hospital, Patras, Greece., Romolo Hospital, Rocca di Neto, Italy.