Abstract
Introduction
To compare the effectiveness and safety of small- and standard-caliber semirigid ureteroscopes for ureteral stones and evaluate whether caliber correlates with intraoperative surgeon stress.Material and methods
In this prospective randomized study, 130 patients underwent ureterorenoscopy using either a 4.5-6.5 Fr (thin) or 8-9.8 Fr (standard) semirigid ureteroscope. The primary endpoint was the stone-free rate (SFR); secondary endpoints included perioperative outcomes and surgeon stress. Stress was assessed using the State-Trait Anxiety Inventory Form TX-1 (STAI-TX1) before and after each procedure, with increased stress defined as ΔSTAI-TX1 > 0. Multivariable logistic regression identified independent predictors of increased stress.Results
Baseline characteristics were comparable. SFRs did not differ significantly between the thin- and standard-caliber groups (92.3% vs. 86.2%, p = 0.25). Balloon dilation (32.3% vs. 4.6%, p Conclusion
Small- and standard-caliber ureteroscopes showed no significant difference in SFRs, but standard-caliber instruments were associated with higher rates of balloon dilation, ureteral injury, and JJ stent placement, as well as increased surgeon-reported stress. Ureteroscope caliber may influence both technical outcomes and the surgeon's intraoperative experience, although stress findings remain exploratory.