International Alliance of Urolithiasis guideline on retrograde intrarenal surgery

Guohua Zeng¹, Olivier Traxer², Wen Zhong¹, Palle Osther³, Margaret S Pearle⁴, Glenn M Preminger⁵, Giorgio Mazzon⁶, Christian Seitz⁷, Petrisor Geavlete^{8

9}, Cristian Fiori¹⁰, Khurshid R Ghani¹¹, Ben H Chew¹², Kah Ann Git¹³, Fabio Carvalho Vicentini¹⁴, Athanasios Papatsoris¹⁵, Marianne Brehmer¹⁶, Juan Lopez Martinez¹⁷, Jiwen Cheng¹⁸, Fan Cheng¹⁹, Xiaofeng Gao²⁰, Nariman Gadzhiev²¹, Amelia Pietropaolo²², Silvia Proietti²³, Zhangqun Ye²⁴, Kemal Sarica²⁵

Affiliations

¹ Department of Urology, Guangdong Key Laboratory of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
² GRC Urolithiasis No. 20, Sorbonne University, Tenon Hospital, Paris, France.
³ Department of Urology, Vejle Hospital-a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark.
⁴ University of Texas Southwestern Medical Center, Dallas, TX, USA.
⁵ Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA.
⁶ Department of Urology, San Bassiano Hospital, Vicenza, Italy.
⁷ Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.
⁸ Sanador Hospital, Bucharest, Romania.
⁹ Department of Urology, Sf. Ioan Emergency Clinical Hospital, Bucharest, Romania.
¹⁰ Division of Urology, Department of Oncology, University of Turin, Turin, Italy.
¹¹ Department of Urology, University of Michigan, Ann Arbor, MI, USA.
¹² Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.
¹³ Department of Urology, Pantai Hospital, Penang, Malaysia.
¹⁴ Departamento de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, Hospital das Clínicas, São Paulo, Brazil.
¹⁵ 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece.
¹⁶ Division of Urology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
¹⁷ Department of Urology, Clinic Hospital, University of Barcelona, Barcelona, Spain.
¹⁸ Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
¹⁹ Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China.
²⁰ Department of Urology, Changhai Hospital, Shanghai, China.
²¹ Department of Urology, Saint-Petersburg State University Hospital, Saint-Petersburg, Russia.
²² Department of Urology, University Hospital Southampton, Southampton, UK.
²³ Department of Urology, IRCCS San Raffaele Hospital, Milan, Italy.
²⁴ Department of Urology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
²⁵ Department of Urology, Medical School, Biruni University, Istanbul, Turkey.

PMID: 35733358
PMCID: PMC10084014
DOI: 10.1111/bju.15836

Review

International Alliance of Urolithiasis guideline on retrograde intrarenal surgery

Guohua Zeng et al. BJU Int. 2023 Feb.

. 2023 Feb;131(2):153-164.

doi: 10.1111/bju.15836. Epub 2022 Jul 12.

Authors

Affiliations

¹ Department of Urology, Guangdong Key Laboratory of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
² GRC Urolithiasis No. 20, Sorbonne University, Tenon Hospital, Paris, France.
³ Department of Urology, Vejle Hospital-a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark.
⁴ University of Texas Southwestern Medical Center, Dallas, TX, USA.
⁵ Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA.
⁶ Department of Urology, San Bassiano Hospital, Vicenza, Italy.
⁷ Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.
⁸ Sanador Hospital, Bucharest, Romania.
⁹ Department of Urology, Sf. Ioan Emergency Clinical Hospital, Bucharest, Romania.
¹⁰ Division of Urology, Department of Oncology, University of Turin, Turin, Italy.
¹¹ Department of Urology, University of Michigan, Ann Arbor, MI, USA.
¹² Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.
¹³ Department of Urology, Pantai Hospital, Penang, Malaysia.
¹⁴ Departamento de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, Hospital das Clínicas, São Paulo, Brazil.
¹⁵ 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece.
¹⁶ Division of Urology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
¹⁷ Department of Urology, Clinic Hospital, University of Barcelona, Barcelona, Spain.
¹⁸ Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
¹⁹ Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China.
²⁰ Department of Urology, Changhai Hospital, Shanghai, China.
²¹ Department of Urology, Saint-Petersburg State University Hospital, Saint-Petersburg, Russia.
²² Department of Urology, University Hospital Southampton, Southampton, UK.
²³ Department of Urology, IRCCS San Raffaele Hospital, Milan, Italy.
²⁴ Department of Urology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
²⁵ Department of Urology, Medical School, Biruni University, Istanbul, Turkey.

PMID: 35733358
PMCID: PMC10084014
DOI: 10.1111/bju.15836

Abstract

Objectives: To set out the second in a series of guidelines on the treatment of urolithiasis by the International Alliance of Urolithiasis that concerns retrograde intrarenal surgery (RIRS), with the aim of providing a clinical framework for urologists performing RIRS.

Materials and methods: After a comprehensive search of RIRS-related literature published between 1 January 1964 and 1 October 2021 from the PubMed database, systematic review and assessment were performed to inform a series of recommendations, which were graded using modified GRADE methodology. Additionally, quality of evidence was classified using a modification of the Oxford Centre for Evidence-Based Medicine Levels of Evidence system. Finally, related comments were provided.

Results: A total of 36 recommendations were developed and graded that covered the following topics: indications and contraindications; preoperative imaging; preoperative ureteric stenting; preoperative medications; peri-operative antibiotics; management of antithrombotic therapy; anaesthesia; patient positioning; equipment; lithotripsy; exit strategy; and complications.

Conclusion: The series of recommendations regarding RIRS, along with the related commentary and supporting documentation, offered here should help provide safe and effective performance of RIRS.

Keywords: #EndoUrology; #KidneyStones; #UroStone; RIRS; flexible ureteroscopy; guideline; retrograde intrarenal surgery; treatment; urolithiasis.

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Comment in

International Alliance of Urolithiasis guideline on retrograde intrarenal surgery.
González-Padilla DA. González-Padilla DA. BJU Int. 2023 Feb;131(2):262. doi: 10.1111/bju.15888. BJU Int. 2023. PMID: 36694103 No abstract available.
Urolithiasis/Endourology.
Assimos DG. Assimos DG. J Urol. 2023 Aug;210(2):375-377. doi: 10.1097/JU.0000000000003538. Epub 2023 May 18. J Urol. 2023. PMID: 37199091 No abstract available.

References

1. Assimos D, Krambeck A, Miller NL et al. Surgical management of stones: American urological association/endourological society guideline. J Urol 2016; 196: 1153–69 - PubMed
1. EAU Guidelines . Edn. presented at the EAU Annual Congress Amsterdam, 2022. ISBN 978‐94‐92671‐16‐5. Available at: https://uroweb.org/guidelines/urolithiasis. Accessed June 2022
1. Zeng G, Zhao Z, Mazzon G, Pearle M et al. European Association of Urology section of urolithiasis and international alliance of urolithiasis joint consensus on retrograde intrarenal surgery for the management of renal stones. Eur Urol Focus 2021; S2405‐4569(21)00290‐X. 10.1016/j.euf.2021.10.011 - DOI - PubMed
1. Zeng G, Zhong W, Mazzon G et al. International Alliance of Urolithiasis (IAU) guideline on percutaneous nephrolithotomy. Minerva Urol Nephrol 2022. 10.23736/S2724-6051.22.04752-8 - DOI - PubMed
1. Guyatt GH, Oxman AD, Vist GE et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008; 336: 924–6 - PMC - PubMed

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International Alliance of Urolithiasis guideline on retrograde intrarenal surgery

Affiliations

International Alliance of Urolithiasis guideline on retrograde intrarenal surgery

Authors

Affiliations

Abstract

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References

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Medical