
A multicenter-based, randomized, controlled trial compared the safety and effectiveness of radiation-free (RF) RIRS versus radiation-usage (RU) RIRS for managing kidney stones. From August 2020 to April 2022, eligible patients with unilateral kidney stones (≤20 mm) were enrolled in 5 tertiary medical centres and randomized into RF and RU groups. Using flexible ureteroscopes with holmium: YAG lasers, RIRS was performed. The primary endpoint was the success rate, defined as complete stone clearance or residual fragments ≤ 3 mm without symptoms. The secondary was to ascertain RF RIRS's safety. Out of 140 participants, 128 completed the study (RF: 63; RU: 65). Success rates (78% vs. 80%, P = .8) did not significantly differ. High-grade ureter injury rates were comparable between RF and RU groups (RF = 3 [4.8%] vs RU = 2 [3.1%], P = .6).
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