What is the best option for a 10-25 mm lower pole stone? Shockwave lithotripsy? Ureteroscopy? Mini percutaneous nephrolithotomy? Standard percutaneous nephrolithotomy? This non-randomized prospective trial will help us answer this question with modern day technology and help us counsel our patients on the pros and cons of each modality.

Study Details

What is the best option for mid sized lower pole stones?

Research question

Patients with stones 13-15 mm can be offered 3 modalities of stone treatment and 4 if you include observation: shockwave lithotripsy, ureteroscopy, percutaneous nephrolithotomy.


  • What offers the best stone free rate?

  • What are the complication rates of each modality?

  • What is the health related quality of life outcomes for each of these modalities?

Inclusion criteria

We are looking for patients who are being treated unilaterally for a lower pole stone burden ranging from 13-15 mm.

Primary Outcome

We will be evaluating the stone free rate and compare each modality.

Secondary Outcomes

  • Quality of life will be very important to help us evaluate our different surgical techniques

  • Complications

Questions to answer

  • Which offers the best stone free rate?

  • which has the best quality of life?

  • What are the costs of each of these procedures?

  • If we observe these stones, how many will become problematic?

Principal Investigators

Dr. Bodo E. Knudsen

Associate Professor, Ohio State University, Columbus, OH, USA

Dr. Alex Meller

Assistant Doctor, Federal University of Sao Paulo, Sao Paulo, Brazil

Mr. Daron Smith

University College London Hospital, London, UK

Contact us to get involved in basic and translational research

We are looking for basic scientists, translational scientists, surgeon scientists, and urologists to become part of this global research initiative.

Please tell us about the following:

  1. your city and location

  2. your area of interest of research

  3. your area of expertise in basic science

  4. You numbers of SWL, ureteroscopies, percutaneous nephrolithotomies.

  5. if you have a new idea for a study you would like help in starting.

Thank you for your interest in TOWER research.


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