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Comparative Study
. 2015:2015:914231.
doi: 10.1155/2015/914231. Epub 2015 Mar 3.

Retrograde intrarenal surgery versus percutaneous lithotripsy to treat renal stones 2-3 cm in diameter

Kursad Zengin  1 , Serhat Tanik  1 , Nihat Karakoyunlu  2 , Nevzat Can Sener  3 , Sebahattin Albayrak  1 , Can Tuygun  2 , Hasan Bakirtas  1 , M Abdurrahim Imamoglu  1 , Mesut Gurdal  1
Affiliations
Comparative Study

Retrograde intrarenal surgery versus percutaneous lithotripsy to treat renal stones 2-3 cm in diameter

Kursad Zengin et al. Biomed Res Int. 2015.

Abstract

Objective: Retrograde intrarenal surgery (RIRS) performed using a flexible ureterorenoscope marked the beginning of a new era in urology. Today, even staghorn stones are successfully treated via RIRS. The recommended treatment for larger stones is percutaneous nephrolithotomy (PNL). However, the question of whether PNL or RIRS should be the first-line treatment option for larger stones remains controversial. In this study, we contribute to the debate by comparing the success and complication rates of PNL and RIRS that were used to treat renal pelvis stones 2-3 cm in diameter.

Materials and methods: The medical records of 154 patients (74 PNL, 80 RIRS) were retrospectively evaluated. PNL patients were placed in Group 1 and RIRS patients in Group 2.

Results: The complete stone-free rates were 95.5% in the PNL group and 80.6% in the RIRS group 1 month postoperatively (P = 0.061). The respective complication rates (evaluated using the Clavien system) were 13.5% and 8.8% (P = 0.520).

Conclusions: RIRS affords a comparable success rate, causes fewer complications than PNL, and seems to be a promising alternative to PNL when larger stones are to be treated. Prospective randomized controlled trials are needed to confirm these findings.

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Figures

Figure 1
Figure 1
Preoperative (a) and postoperative (b) X-rays of a patient with a 21 mm diameter kidney stone treated via percutaneous nephrolithotomy.
See this image and copyright information in PMC

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