Meta-analysis: no overall SFR difference between primary and delayed ureteroscopy for obstructing stones

Meta-analysis · Eur Urol Open Sci · 2026-10-21. Number 4 in the UrologyWatch Top 5 for October 21, 2026.

Pooled data from 15 studies (19,907 patients) found no significant difference in stone-free rates between primary ureteroscopy (within 24-48 hours) and delayed ureteroscopy (OR 1.20, 95% CI 0.75-1.92, I2=86%). In a subgroup of 5 studies using a zero-fragment imaging definition, primary URS had higher odds of stone-free status (OR 1.49, 95% CI 1.10-2.02); a sensitivity analysis of 2 CT-based trials with strict…

Why it matters: Supports flexibility in ureteroscopy timing overall, but the zero-fragment subgroup signal favoring primary URS stems from few studies and needs confirmation given heterogeneity in the full analysis.

Limitation: Predominantly retrospective studies with substantial heterogeneity (I2=86%); subgroup analyses based on few studies with wide confidence intervals.

Source: Eur Urol Open Sci · PubMed 42898237 · DOI 10.1016/j.euros.2026.09.007

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