Comparison between Extracorporeal Shock Wave Lithotripsy (ESWL) and flexible Ureterorenoscopy (URS) in the management of renal stones less than 1.5 cm

Background: The optimal management of renal stones less than 1.5 cm remains debated, with extracorporeal shock wave lithotripsy (ESWL) and flexible Ureterorenoscopy (URS) being the most commonly employed minimally invasive modalities where in This study aimed to compare the efficacy, safety, cost-effectiveness, and patient-centered outcomes of ESWL and flexible URS in adult patients with small renal stones, Methods: In this single-center prospective cohort study, 120 adult patients with renal stones ≤1.5 cm were randomized to receive either ESWL (N=60) or flexible URS (N=60). Baseline demographics, stone characteristics, and clinical history were recorded additionally the primary outcome was the stone-free rate at 3 months post-treatment also were Secondary outcomes included procedure duration, complication rates (Clavien-Dindo classification), retreatment and auxiliary procedure rates, inflammatory markers (CRP, WBC), cost analysis, quality of life (SF-36), and patient satisfaction. Statistical analysis was performed using t-tests, chi-square tests, and multivariate regression as appropriate, the Results: which found in this study were The stone-free rate at 3 months was significantly higher in the URS group (86.7%) compared to the ESWL group (63.3%; P=0.003) and Retreatment rates were higher in the ESWL group (33.3% vs. 8.3%; p