The impact of normalized energy utilization on clinical outcomes and complications in endourological stone surgery: a prospective study

BAŞARANOĞLU,MERT | KUŞ,OKTAY | TEK,MESUT | AKBAY,ERDEM

Abstract · This prospective study evaluated the impact of normalized energy utilization on clinical outcomes and complications in endourological stone surgery. Between January 2024 and April 2025, 478 consecutive patients undergoing holmium: YAG laser lithotripsy were enrolled. Stone characteristics, energy parameters, operative outcomes, and complications were prospectively recorded. Normalized energy values (J/mm³) were calculated as total energy divided by stone volume. The primary endpoint was complication development. Mean normalized energy was 22.5 ± 13.1 J/mm³ (range: 5.8–72.4). High-density stones (> 1000 HU) and lower calyceal locations required significantly higher energy (p < 0.001 and p = 0.012, respectively). ROC analysis identified 25 J/mm³ as the optimal threshold for predic...