Gauhar V.Castellani D.Kalathia J.Mehta A.Gadzhiev N.Malkhasyan V.Kumar N.Kalbit R.H.Gorgotsky I.Gokce M.i.Laymon M.Inoue T.Tak G.R.Baker A.Dholaria P.Chawla A.Beltrán-Suárez E.Mahajan A.Fong K.Y.Yuen S.K.K.Tan K.Omar M.Petkova K.Taguchi K.Ketsuwan C.Lakmichi M.A.Palaniappan S.Tanidir Y.Akdogan N.Cepeda M.Martov A.Tokhtiyev Z.Tzelves L.Skolarikos A.Acuña E.Zawadzki M.Kamal W.Lopes L.G.Gorelov D.Agrawal M.S.Vaddi C.M.Somani B.K.Herrmann T.R.W.Mahidol University2025-05-232025-05-232025-12-01World Journal of Urology Vol.43 No.1 (2025)07244983https://repository.li.mahidol.ac.th/handle/123456789/110323Purpose: To present outcomes of a registry to understand the practice patterns, resource utilization, and nuances of suction mini-percutaneous nephron lithotripsy (SM-PCNL). Methods: Data from 30 centers in 21 countries were prospectively collected (March–November 2024). SM-PCNL was defined as PCNL using a suction nephrostomy sheath of size 14–22 Fr. with any lithotripsy device. There were no instructions on how to perform the surgical procedure. Stone features and stone-free status were assessed using an unenhanced CT scan. Data are presented as median/interquartile range and frequency/proportion. Results: 1707 patients were included and 42.4% of them were males. Most were first-time stone formers. Median age was 50 years. Median stone volume was 1700 mm3. Surgery was commonly performed using a single access tract (92.9%) and in supine position (56.5%). The fluoroscopy-only puncture was used as the most common access (70.7%), followed by the combination of fluoroscopy and ultrasound (25.1%). Median operation time was 45 min. The most common sheath was Clearpetra (27.8%). Thulium fiber laser was the most frequent energy used (26.2%). A tubeless procedure with a stent was employed in 47.0% of cases. Most common complications were fever managed by observation (7.3%), fever requiring antibiotics (3.3%), blood transfusion (1.1%), and sepsis (0.2%). Median hospitalization was 3 days. 30-day CT scan showed zero fragments in 82.4% of patients. Reintervention was performed in 2.6% of cases. Conclusions: This registry outlines the various equipment, peri-operative strategies, complications, and outcomes of SM-PCNL performed in real-world practice, providing valuable data on the nuances of performing such surgery.MedicineArticleSCOPUS10.1007/s00345-025-05656-82-s2.0-10500507889914338726