Comparative Study between Retrograde Intrarenal Surgery and Percutaneous Nephrolithotomy for the Treatment of Renal Stones

Abstract

Background: The prevalence of urolithiasis has increased during the last decades and now affects approximately 9% of the adult population specially in developed countries. European Urology Guidelines recommend PCNL in stones larger than 2 cm in size and ESWL in stones smaller than 2 cm in size as the first treatment option. With advances in technology, new generation flexible ureteroscopes with safe and effective lithotripters such as holmium laser have been developed and RIRS became an important alternative in the treatment of large urinary stones.
 Objective: To evaluate the safety and efficacy of retrograde intrarenal surgery (RIRS) in the treatment of kidney stones and to compare its results with those of percutaneous nephrolithotomy (PCNL).
 Materials and Methods: We retrospectively analyzed a total of 50 patients ─ 27 patients (20 males and 7 females) who underwent PCNL and 23 patients (17 males and 6 females) who underwent RIRS between January 2015 and December 2017.
 Results: The mean duration of operation was 60.65 ± 23.56 minutes in the RIRS group and 50.55 ± 12.77 minutes in the PCNL group (p<0.047). The hospital stay was significantly shorter in the RIRS group (2.21 ± 0.9 vs 5.29 ± 1.53 days in the RIRS and PCNL groups, respectively; p<0.016). Stone-free rates after one session were 88.6% and 84.8% in the RIRS and PCNL groups respectively. Blood transfusions were required in five patients in the PCNL group. Complication rates were higher in the PCNL group.
 Conclusion: This study reveals that RIRS can be an alternative to PCNL in the treatment of kidney stone.
 J Enam Med Col 2019; 9(2): 84-89

Comparison Between Percutaneous Nephrolithotomy and Retrograde Flexible Nephrolithotripsy in Obese Patients with 2 - 4 cm Renal Stones

“…Akman et al showed that the SFR of PNCL and RIRS were significantly different (91.2% and 73.5%, respectively) in non-obese patients with 2 -4 cm renal stones of different compositions (4). The successful (28). In the current study, after a single procedure, the SFR for PCNL was about 95% and for RIRS was 92%, which was higher than in recent studies.…”

“…Hospital stay in the PCNL group was significantly higher than in the RIRS group. This difference can be explained by some reasons, including necessitating catheter insertion for drainage and following patients following blood transfusion in patients of the PCNL group (28). Recent studies show that performing PCNL procedures without a tube significantly decreases hospital duration (35,36).…”