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Purpose: Kidney stone disease affects 5% of the population and is associated with non-negligible morbidity. Retrograde intrarenal surgery and percutaneous nephrolithotomy are the treatments of choice. We analyzed the results from our patients who underwent retrograde intrarenal surgery at controlled pressure. Materials and Methods: We conducted an observational, descriptive, retrospective study of 403 patients who underwent retrograde intrarenal surgery at the Hospital Clínico Universitario Lozano Blesa (Zaragoza, Spain) between January 2013 and December 2019. Results: The mean surgical time was 111.1 minutes, with a mean stone volume of 3.5 cm 3 (maximum volume, 38.3 cm 3 ). A total of 70 patients (17.3%) developed postoperative Clavien-Dindo complications-64 minor (91.4%) and 6 major (8.6%). In addition, 28 patients (6.9%) presented with an early complication (<3 months), with urinary tract infection and pyelonephritis being the most common. The stone-free rate was 69.0%, with a retreatment rate of 4.7%. Conclusions: Sex was statistically significantly related to the onset of minor Clavien postoperative complications (p = 0.001). Similarly, corticosteroid use was associated with the onset of major Clavien complications (p = 0.030). Neither surgical time nor stone volume was found to be statistically significantly related to the onset of Clavien postoperative complications or early complications.

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years was 90.3% (n[90) and 66.9% (n[69). The median SFS was 27.9 months. CSS at 1 and 3 years was 92.2% and 43.7%, respectively. 78.6% of the patients were symptom-free during their remaining lifetime.CONCLUSIONS: Multivisceral radical pelvic surgery is a technically feasible approach in well-selected patients resulting in symptom relief of > 90% of patients which covered almost 80% of the remaining life time. Palliative surgery needs to be considered more frequently iin the therapeutic armentarium of locally symptomatic CRPC. Adequate preoperative imaging studies, endoscopic evaluation and extensive surgical experience is mandatory to achieving a benefit for the individual patient with improvement of quality of life.