Comparison stone-free rate and effects on quality of life of percutaneous nephrolithotomy and retrograde intrarenal surgery for treatment of renal pelvis stone (2-4 cm): A prospective controlled study

Abstract

Objectives: The aim of our study was to compare the effects on quality of life (QoL) and stone-free rate (SFR) of percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) in patients with renal stones 2-4 cm. Materials and methods: A total of 102 patients with renal pelvis stones were enrolled in this prospective controlled study, of which 52 were performed RIRS and 50 with PNL. The QoL was evaluated by using Short From-36 pre-and post-operatively. Also, the surgical data of all patients during and after the operations were compared between the 2 groups. Results: The mean age, body mass index, stone size and density of the patients in the 2 groups were statistically similar (p > 0.05). The SFR of PNL and RIRS were found 94% (47/50) and 73% (38/52), respectively (p < 0.01). There were no statistically differences between operation times, minor complication rates and Short From-36 scores of the 2 groups. Hospitalization times were 1.13 ± 0.34 days for RIRS and 2.9 ± 5.7 days for PNL (p < 0.05). While the blood transfusion rate of PNL group was 8% (4/50), none patient was made blood transfusion in RIRS. Conclusions:The results of our study show that the blood transfusion rates and hospitalization times of RIRS group are significantly lower than PNL for management of renal pelvis stone 2-4 cm. Despite these advantages of RIRS, the SFR is significantly lower than PNL for these stones. The effects on QoL of the both interventions before and after surgery were similar.

Urologists are optimistic surgeons: prevalence and predictors of discordance between intraoperative stone-free rate and cross-sectional imaging evaluation after vacuum-assisted mini-percutaneous nephrolithotomy

“…However, nowadays, there is yet not a unified definition and we aimed to be more rigorous in terms of PCNL outcomes. In fact, it should be mentioned that SFR in our series was lower compared to that reported by different authors for the treatment of kidney stones with mPCNL (range 80-95%) [37,38]. However, in the previous series, the authors considered SF also cases with residual fragments of < 4 mm or used plain X-ray for evaluation, thus partially explaining the difference in SFR with our series.…”

Prevalence and predictors of unfavourable risk factors of trifecta in vacuum assisted mini- percutaneous nephrolithotomy: a single center experience

“…It should be mentioned that SFR in our series (76.4%) was lower compared to that reported by different Authors for the treatment of > 2 cm kidney stones with PCNL (range 86%-94%) and similar to that of retrograde intrarenal surgery (RIRS) (61%-80%) [25][26][27]. Of note, it was consistently reported that RIRS was associated with shorter hospitalization time, lower rates of complications and acceptable e cacy than PCNL, therefore it should be considerate as an alternative treatment option in this group of patients [26].…”

Is There Still a Place for Percutaneous Nephrolithotomy in Current Times?

“…PCNL is historically considered the standard of care for the treatment of staghorn calculi [ 18 ]. Usually, ureteroscopic management of these calculi is considered inferior to PCNL due to its low stone-free rates (SFRs) and the need for multiple sessions [ 19 , 20 , 21 ]. A recent meta-analysis explored the integration of ureteroscopy with PCNL in a combined antegrade and retrograde approach for the treatment of staghorn calculi [ 22 ].…”