Outcome of retrograde flexible ureterorenoscopy and laser lithotripsy for treatment of multiple renal stones

Alazaby, Hisham; Khalil, Maria; Omar, Rabea; Mohey, Ahmed; Gharib, Tarek; Abo-Taleb, Ahmed; El-Barky, Ehab

doi:10.1016/j.afju.2018.01.002

Cited by 5 publications

(7 citation statements)

References 26 publications

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“…Our results showed that RIRS had a clear advantage in postoperative hospital stay compared with mini-PCNL. Patient recovery tends to be faster with RIRS, which was also supported by the studies of Bai et al[17] and Alazaby et al[18] The hospitalization cost was an important issue when comparing the different treatment modalities. RIRS surgery at our institution costs $2624 compared to $3255 for mini-PCNL technique, which translates into a savings of $631 per case.…”

Section: Discussionmentioning

confidence: 54%

Retrograde intrarenal surgery vs miniaturized percutaneous nephrolithotomy to treat lower pole renal stones 1.5-2.5 cm in diameter

Li¹,

Yang²,

Liu³

et al. 2018

WJCC

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AIMTo compare the outcomes of retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mini-PCNL) in treating lower pole (LP) renal stones with a diameter of 1.5-2.5 cm.METHODSA total of 216 patients who underwent mini-PCNL (n = 103) or RIRS n = 113) for LP stones with a diameter of 1.5-2.5 cm were enrolled between December 2015 and April 2017 at the Urology Department of Ningbo Urology and Nephrology Hospital.RESULTSSignificant differences were found in the hospital stay (9.39 ± 4.01 vs 14.08 ± 5.26, P < 0.0001) and hospitalization costs (2624.5 ± 513.36 vs 3255.2 ± 976.5, P < 0.0001) between the RIRS and mini-PCNL groups. The mean operation time was not significantly different between the RIRS group (56.48 ± 24.77) and the mini-PCNL group (60.04 ± 30.38, P = 0.345). The stone-free rates at the first postoperative day (RIRS vs mini-PCNL: 90.2% vs 93.2%, P = 0.822) and the second month postoperatively (RIRS vs mini-PCNL: 93.8% vs 95.1%, P = 0.986) were not significantly different.CONCLUSIONRIRS and mini-PCNL are both safe and effective methods for treating LP stones with a diameter of 1.5-2.5 cm. RIRS can be considered as an alternative to PCNL for the treatment for LP stones of 1.5-2.5 cm.

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Section: Discussionmentioning

confidence: 54%

Retrograde intrarenal surgery vs miniaturized percutaneous nephrolithotomy to treat lower pole renal stones 1.5-2.5 cm in diameter

Li¹,

Yang²,

Liu³

et al. 2018

WJCC

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“…In our review, four treatment modalities were identified for complex renal stones, all of which were surgical interventions [13][14][15][16][17][18][19][20][21][22][23]. These included percutaneous nephrolithotomy (PCNL), open surgery, laparoscopic surgery, and retrograde intrarenal surgery (RIRS).…”

Section: Treatment Modalitiesmentioning

confidence: 99%

“…Open surgery was performed in five studies accounting for 21.1 % of patients (320 cases, 358 renal units) [ 15 , 16 , 19 , 20 , 22 ]. Various surgical techniques were applied, including open pyelotomy, nephrolithotomy, and pyelonephrolithotomy, with four patients requiring nephrectomy due to their stones.…”

Section: Reviewmentioning

confidence: 99%

“…Laparoscopic pyelolithotomy was employed in one study for stone treatment in 62 patients (4.1%), achieving a 100% stone-free rate [ 22 ]. Retrograde intrarenal surgery (RIRS) on the other hand was utilised in one study involving 42 patients (2.8%), demonstrating a stone-free rate of 92.8% without requiring any auxiliary procedures [ 15 ]. The summary of treatment modalities is represented in Figure 3 .…”

Section: Reviewmentioning

confidence: 99%

“…To assess stone clearance, most studies utilized plain kidney, ureter and bladder (KUB) ultrasound between postoperative days 1 and 14 [ 13 , 14 , 16 , 20 , 21 ], with non-contrast CT requested thereafter if a radiolucent stone was suspected. However, three studies directly opted for non-contrast CT to assess stone clearance [ 15 , 17 , 18 ]. A stone larger than 4mm detected postoperatively was recorded as indicative of a failed procedure.…”

Section: Reviewmentioning

confidence: 99%

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Current Practices and Challenges in the Management of Complex Renal Stones in Africa: A Scoping Review

Abdulrasheed,

George,

Ayobami-Ojo

et al. 2024

Cureus

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This study reviews the challenges and management strategies for complex renal stones in Africa. Historically viewed as infection or struvite stones, recent studies highlight diverse compositions of staghorn stones. These complex stones pose significant risks, including recurrent urinary tract infections and renal impairment. In the past, conservative management of staghorn stones was associated with high morbidity; thus, surgical intervention was necessary for complete eradication. While percutaneous nephrolithotomy (PCNL) remains the standard, it carries notable risks, leading to a shift towards minimally invasive techniques. This study reviews challenges and management practices for complex renal stones and staghorn calculi in African countries, evaluating stone-free rates and associated complications.A scoping review of the literature, following the Preferred Reporting Items for Systematic Reviews and Metaanalysis guidelines, was performed. A systematic search was conducted in PubMed, African Journal Online (AJOL) and Google Scholar, yielding 1,101 articles, but only 11 articles satisfied the inclusion criteria.The study included 1,513 patients with 1,582 renal units, predominantly male (67.2%) with an average age of 40.7 years. Percutaneous nephrolithotomy (PCNL) was the primary treatment for the majority (71.3%), followed by open surgery (21.9%), laparoscopic surgery (4.1%), and retrograde intrarenal surgery (RIRS) (2.7%). The stone clearance rates for PCNL, open surgery, laparoscopic pyelolithotomy, and RIRS were 82.8%, 83.7%, 100%, and 92.8%, respectively. Stone sizes ranged between 22 and 80 mm, with 66% being staghorn stones. Complication rates were highest for open surgery (30.8%) and lowest for RIRS (4.7%).Despite PCNL being the global standard, African studies still indicate a high reliance on open surgery, likely due to healthcare infrastructure, resource availability and socioeconomic factors. Enhancing access to urological care and addressing healthcare disparities are imperative for improving staghorn stone management in Africa.

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Efficacy of flexible ureterorenoscopy in treating multiple renal stones: a cohort study

Mahmood,

Bapir,

Mustafa

et al. 2024

Arch Ital Urol Androl

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Introduction: While the efficacy of flexible ureterorenoscopy (URS) in managing solitary kidney stones (KSs) is widely acknowledged, its effectiveness in treating multiple stones has scarcely been investigated. This study aims to assess the effectiveness and safety of retrograde intrarenal surgery (RIRS) utilizing flexible URS and laser lithotripsy in the management of multiple KSs. Methods: This study was a single-group cohort study conducted on patients with multiple KSs who underwent treatment with RIRS using flexible URS and laser lithotripsy. Stone-free status was considered as the lack of residual stone fragments or any residual stone of any size. The first follow-up appointment was arranged 3-4 weeks following the procedure. If significant residual stones were present, patients underwent reintervention within 2-4 weeks. Results: A total of 110 patients with multiple KSs were included. The mean stone burden was 27.5 ± 7.9 mm, and the mean duration of the operation was 54.9 ± 19.7 minutes. Seven cases (6.3%) experienced intraoperative complications, while postoperative complications were found in eight cases (7.3%). After four weeks, a stone-free rate (SFR) was documented in 80.9% of the cases, and this rate increased to 93.6% after three months. The SFR after three months was significant with Guy’s stone score (p < 0.001); however, it did not reach a significant level with any other parameters. Conclusions: The RIRS with flexible URS may be an effective and potentially safe procedure for treating multiple KSs. It may yield a favorable SFR with an acceptable complication rate.

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Outcome of retrograde flexible ureterorenoscopy and laser lithotripsy for treatment of multiple renal stones

Cited by 5 publications

References 26 publications

Retrograde intrarenal surgery vs miniaturized percutaneous nephrolithotomy to treat lower pole renal stones 1.5-2.5 cm in diameter

Retrograde intrarenal surgery vs miniaturized percutaneous nephrolithotomy to treat lower pole renal stones 1.5-2.5 cm in diameter

Current Practices and Challenges in the Management of Complex Renal Stones in Africa: A Scoping Review

Efficacy of flexible ureterorenoscopy in treating multiple renal stones: a cohort study

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