Treatment Outcomes of Retrograde Intrarenal Surgery for Renal Stones and Predictive Factors of Stone-Free

Abstract

PurposeThe aim of this study was to evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) for the treatment of renal stones and to analyze the predictive factors for stone-free.Materials and MethodsWe retrospectively reviewed the records of patients who underwent RIRS for renal stones from January 2000 to July 2009. We identified 66 RIRSs (63 patients with 3 bilateral renal stones) and collected data. Stone-free and success were respectively defined as no visible stones and clinically insignificant residual stones less than 3 mm on postoperative imaging; predictive factors for stone-free were evaluated.ResultsOf the 66 renal stones, 18 stones (27.3%) were located in the upper pole or midpole or renal pelvis and 48 (72.7%) in the lower pole with or without others, respectively. The mean cumulative stone burden was 168.9±392.5 mm2. The immediate postoperative stone-free rate was 69.7%, and it increased to 72.7% at 1 month after surgery. The success rate was 80.3% both immediately after the operation and 1 month later. In the multivariate analysis, stone location except at the lower pole (p=0.049) and small cumulative stone burden (p=0.002) were significantly favorable predictive factors for the immediate postoperative stone-free rate. The overall complication rate was 6%.ConclusionsRIRS is a safe and effective treatment for renal stones. The stone-free rate of RIRS was particularly high for renal stones with a small burden, except for those located in the lower pole. RIRS could be considered in selective patients with renal stones.

Factors associated with postoperative pain after retrograde intrarenal surgery for kidney stones

“…Thus RIRS became a common endourologic procedure for the treatment of renal stones with high success rates. [1][2][3][4][5][6] The RIRS procedure can be considered as a safe method due to rarely occurence of major complications as classified according to Satava III or Clavien III-V criteria. [7,8] Only a limited number of studies so far have investigated the complications developed after RIRS, and they only presented some severe complications of the procedure.…”

“…[7,8] Only a limited number of studies so far have investigated the complications developed after RIRS, and they only presented some severe complications of the procedure. [3,5,6] But none of them investigated the postoperative pain as a complication, because it is a rather subjective symptom. A classification system has been used for categorizing intraoperative complications of RIRS by using modified Satava classification system for the first time, recently [7] , however because the study was designed in a retrospective nature, colic pain was not evaluated as a complication.…”

“…[1][2][3][4][5][6] Retrograde intrarenal surgery can be considered as a quite safe method because major complications rarely occur after the procedure. [7] However, only a limited number of studies have investigated the complications after RIRS.…”

“…[7] However, only a limited number of studies have investigated the complications after RIRS. [3,5,6] Those publications mention some complications of their series, and a few of them focus on the procedural postoperative pain. We categorized intraoperative complications of RIRS by using modified Satava classification system for the first time [7] , but we did not evaluate the postoperative pain as a complication because it is rather subjective.…”

Retrograde Intrarenal Surgery with Combined Spinal-Epidural vs General Anesthesia: A Prospective Randomized Controlled Trial

“…SFR was defined as complete stone clearance or residual fragments, 3 mm or smaller, at 1 month by the evaluation of the CT scan. 4 In patients with residual calculi, repeated RIRS and ESWL were considered as auxiliary treatment alternatives when indicated.…”