Is Retrograde Intrarenal Surgery with Semi-rigid Ureterorenoscope Feasible for Isolated Renal Pelvic Stones?

Abstract

Objective:We compared the success and complication rates of retrograde intrarenal surgery (RIRS) performed with semi-rigid ureterorenoscopy (srURS) or flexible ureterorenoscopy (fURS) for isolated renal pelvic stones.Materials and Methods:A total of 247 patients who underwent RIRS with fURS (n=179; group 1) or srURS (n=68; group 2) were included in this study. Various factors related to patients, stones and surgical procedures were evaluated retrospectively.Results:There was no difference between the patient groups according to mean age (49.12±1.10 years vs 49.59±1.60 years, p=0.745), gender distribution (p=0.152), mean hounsfield unit values (941±31.41 vs 1036±44.47 p=0.077), and mean hospitalization time (3.57±0.19 days vs 4.59±0.57, p=0.224). In group 1, the mean stone size (14.5±0.73 mm vs 15.5±0.62 mm, p=0.019) was statistically lower and the operative time (79.73±3.38 min vs 70.65±8.61, p=0.041) was statistically higher than those of group 2. The overall success rate in group 1 and group 2 was 93.9% and 63.6%, respectively (p<0.0001). The complication rate in group 2 (23.5%) was higher than that of the group 1 (12.3%) (p=0.047).Conclusion:According to our results, the success rate of srURS was lower and the complication rate was higher than that of fURS. Therefore, we conclude that srURS was unsafe and unsuccessful for use in the treatment of pelvic stones. Prospective studies involving intrarenal pressure measurement and cost analysis must reach a conclusion in this respect.

Keywords

• urolithiasis
• nephrolithiasis
• ureteroscopy
• retrograde intrarenal surgery