Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2022 Feb;50(1):113-117.
doi: 10.1007/s00240-021-01289-9. Epub 2021 Nov 22.

Retrograde intrarenal surgery versus percutaneous nephrolithotomy for treatment of renal pelvic stone more than 2 centimeters: a prospective randomized controlled trial

Maged Kamal Fayad  1   2 , Omar Fahmy  3 , Khaled Mukhtar Abulazayem  2 , Nashaat M Salama  4   5
Affiliations
Randomized Controlled Trial

Retrograde intrarenal surgery versus percutaneous nephrolithotomy for treatment of renal pelvic stone more than 2 centimeters: a prospective randomized controlled trial

Maged Kamal Fayad et al. Urolithiasis. 2022 Feb.

Abstract

This study aimed at investigating the efficacy and safety of retrograde intrarenal surgery (RIRS) in treatment of renal pelvic stone larger than 2 cm against the percutaneous nephrolithotomy (PCNL). Between March 2018 and December 2020, 121 patients were randomized to undergo PCNL (60 patients), or RIRS (61 patients). Both groups were compared in terms of operative time, intraoperative complications. Postoperative complications were assessed based on Clavien-Dindo grading system. Stone-free rates were evaluated by CT scan 6 weeks after surgery. No significant difference were observed between both groups in perioperative criteria. The main operative time was slightly longer in PCNL group (105 vs 95 min, p = 0.49). Stone clearance was higher in PCNL, yet the difference was not significant. (53 patients in PCNL group had either complete clearance or residual fragments < 4 mm, compared to 49 in RIRS group (p = 0.22). Blood transfusion rate was 8.3% in PCNL compared to 1.6% in RIRS group, with a trend towards significance (p = 0.08). Post-operative fever was higher in RIRS, yet it fell just short of statistical significance (13.1% vs 5.0%, p = 0.12). Compared to PCNL, RIRS displayed acceptable efficacy with less risk of bleeding requiring transfusion. It can be applied to patients with large renal pelvic stone as an alternative to PCNL.

Keywords: Flexible ureteroscopy; Percutaneous nephrolithotomy; Renal stones; Retrograde intrarenal surgery; Urolithiasis.

PubMed Disclaimer

References

    1. Trinchieri A (2008) Epidemiology of urolithiasis: an update. Clin Cases Miner Bone Metab: Off J Ital Soc Osteoporos, Miner Metab, Skelet Dis 5(2):101–106
    1. Junbo L, Yugen L, Guo J, Jing H, Ruichao Y, Tao W (2019) Retrograde intrarenal surgery vs. percutaneous nephrolithotomy vs. extracorporeal shock wave lithotripsy for lower pole renal stones 10–20 mm: a meta-analysis and systematic review. Urol J 16(2):97–106. https://doi.org/10.22037/uj.v0i0.4681 - DOI - PubMed
    1. Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, Knoll T (2016) EAU guidelines on interventional treatment for urolithiasis. Eur Urol 69(3):475–482. https://doi.org/10.1016/j.eururo.2015.07.041 - DOI - PubMed
    1. Geraghty R, Abourmarzouk O, Rai B, Biyani CS, Rukin NJ, Somani BK (2015) Evidence for ureterorenoscopy and laser fragmentation (URSL) for large renal stones in the modern era. Curr Urol Rep 16(8):54. https://doi.org/10.1007/s11934-015-0529-3 - DOI - PubMed
    1. Geraghty RM, Ishii H, Somani BK (2016) Outcomes of flexible ureteroscopy and laser fragmentation for treatment of large renal stones with and without the use of ureteral access sheaths: results from a university hospital with a review of literature. Scand J Urol 50(3):216–219. https://doi.org/10.3109/21681805.2015.1121407 - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources