Abstract：Objective: To evaluate the efficacy of flexible ureterorenoscopy with holmium laser lithotripsy(FURS) in management of lower pole stones. Methods: Ninety-three cases of lower pole stone received FURS between January 2015 and March 2017. The residual stones and the position of double-J stents were evaluated with kidney, ureter and bladder X-ray (KUB) on the first postoperative day. Patients can be discharged from hospital on the third postoperative day. The double-J stents were removed on the second postoperative week. The stone-free rate of all patients was evaluated using KUB on the first postoperative month. Results: All 93 patients were treated successfully. The median stone size was (14.6±4.5) mm. The mean operation time was (68.2±19.1) min. The mean hospital stay was (3.9±1.0) d. The final stone-free rate of all patients was 79.5% (74/93) on fist month postoperatively. In the groups of stone diameter <20 mm and ≥20 mm, the stone-free rate was 87.3% (62/71) and 54.5% (12/22) respectively with the difference being statistically significant between two groups (χ2=11.101, P=0.001). The stone-free rate in patients with the infundibulopelvic angle (IPA) >30° and IPA ≤30° was 88.7% (55/62) and 61.2% (19/31) respectively with the difference being statistically significant between two groups (χ2=9.556, P=0.002). Postoperative fever greater than 38.5℃ was noted in 7 cases. No other severe complication occurred. Conclusions: The FURS was a safe and effective way to treat lower pole stones, with a low complication rate. It can be a main method for the treatment of lower pole stones in some selective patients. But the stone size and IPA can significantly impact the stone-free rate.
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