Effectiveness of Flexible Ureterorenoscopy and Laser Lithotripsy for Multiple Unilateral Intrarenal Stones Smaller Than 2 cm

Abstract

Purpose. To evaluate the safety and efficacy of RIRS for the treatment of multiple unilateral intrarenal stones smaller than 20 mm. Methods. Between March 2007 and April 2013, patients with multiple intrarenal stones smaller than 20 mm were treated with RIRS and evaluated retrospectively. Each patient was evaluated for stone number, stone burden (cumulative stone length), operative time, SFRs, and complications. Results. 173 intrarenal stones in 48 patients were included. Mean age, mean number of stones per patient, mean stone burden, and mean operative time were 40.2 ± 10.9 years (23–63), 3.6 ± 3.0 (2–18), 22.2 ± 8.4 mm (12–45), and 60.3 ± 22.0 minutes (30–130), respectively. The overall SFR was 91.7%. SFRs for patients with a stone burden less and greater than 20 mm were 100% (23/23) and 84% (21/25), respectively (χ 2 = 26.022, P < 0.001). Complications occurred in six (12.5%–6/48) patients, including urinary tract infection or high-grade fever >38.5°C in three cases, prolonged hematuria in two cases, and ureteral perforation in one case, all of whom were treated conservatively. No major complications occurred. Conclusions. RIRS is an effective treatment option in patients with multiple unilateral intrarenal stones especially when the total stone burden is less than 20 mm.

Retrograde intrarenal surgery for renal stones - Part 2

“…Alkan et al [50] published their results for 173 stones in 48 patients with multiple unilateral stones. RIRS was performed as a primary procedure in 81.2%, after SWL in 14.6% and after PCNL in 4.2% of the patients.…”

Utility of Flexible Ureterorenoscopy and Laser Lithotripsy in the Treatment of Multiple Intrarenal Stones

“…The SFRs for patients with stone burdens <20 mm and >20 mm were 100% (23/23) and 84% (21/25), respectively. Minor complications developed in six patients, but no major complications were noted (6). In the present study, we evaluated the RIRS success rates in patients with multiple intrarenal stones who underwent a single procedure.…”

“…The total stone burden was the sum of all stone diameters (3,6,8). Preoperative urinalyses and cultures were performed and appropriate antibiotics were prescribed if necessary.…”

“…In clinical practice, the most widely used parameter is cumulative diameter (3,6,8), as in the present study. However, since this parameter does not show stone width or depth, stone volume has been proposed to be a more reliable method for confirming stonefree status.…”

“…With PCNL and ESWL, there is also a need for multiple interventions for multiple renal stones in different locations. Although only a few studies have evaluated RIRS for the treatment of multiple renal stones, they have reported low interventions with high success rates (3,4,5,6,7).…”