17 Angelo Cormio Vineet Gauhar Bhaskar K. Somani Jaisukh Kalathia Nariman Gadzhiev Marek Zawadzki Mahmoud Laymon Karl Tan Gopal Ramdas Tak Theodoros Tokas Madhu Sudan Agrawal Jean de la Rosette Kremena Petkova Kazumi Taguchi Dmitriy Gorelov Alexey G. Martov Leonardo Gomes Lopes Mehmet ilker Gökce Wissam Kamal Stefania Ferretti Devang Desai Yadgar Abduljabbar Shwani Khi Yung Fong Steffi Kar Kei Yuen Andreas Skolarikos Marcos Cepeda Thomas R. W. Herrmann Daniele Castellani kidney calculi laser percutaneous nephrolithotomy sheath suction Scopus Web of Science 2025 2026-05-24 10.1002/bco2.70075 BJUI COMPASS Objectives: To compare perioperative outcomes, complications and stone-free rates (SFRs) between laser and non-laser lithotripsy in suction-assisted mini-PCNL (SM-PCNL). Subjects and Methods: This prospective multicentre study enrolled adults with normal kidneys undergoing SM-PCNL (14–22 Fr) across 30 international centres (March–November 2024). Patients were divided into laser (Group 1) and non-laser (Group 2) groups. Propensity score matching (2:1) was performed based on age, sex, Guy’s score and patient position. Primary outcomes were complications and 30-day SFR assessed by CT. Multivariable logistic regression identified predictors of complete stone clearance and complications. Results: After matching, 748 patients were analysed (Group 1: 448; Group 2: 300). Non-laser devices were associated with shorter lithotripsy (12 vs 18 min, p < 0.001) and operative times (37 vs 45 min, p < 0.001) and higher SFR (intraoperative: 91.3% vs 80.7%; 30-day: 87.7% vs 82.1%). However, transfusions (3.3% vs 0.2%), pelvic perforation and pleural injury (each 3.0%) were more common in Group 2. On multivariable analysis, single-step dilation (OR 3.05) and sheath sizes of 16.5–18 Fr (OR 1.98) or 20–22 Fr (OR 2.72) were associated with higher odds of stone-free status, while skin-to-stone distance >8 cm (OR 0.5) and combined fluoroscopy/ultrasound access (0.28) reduced this likelihood. Stone volume (OR 1.03), serial dilation with non-metal dilators (OR 2.64) and combined fluoroscopy/ultrasound access (OR 2.11) were factors associated with higher odds of complications. The lithotripsy technology had no direct bearing on complications. Conclusions: Both laser and non-laser lithotripsy are effective in SM-PCNL. Nonlaser devices improve efficiency and lasers were preferentially used with 14–18 fr access tracts. https://repo.bashgmu.ru/publication/5407 https://repo.bashgmu.ru/files/5601