Retrograde intrarenal surgery: An expanding role in treatment of urolithiasis

Abstract

During the past 3 decades, the surgical management of kidney stones has undergone many technological advances and one is the development of the flexible ureteroscopy. The development of this instrument as well as ancillary equipment such as baskets, graspers, and others, and improvements in lithotripsy with Holmium: YAG laser have led to expand its indications with diagnostic and therapeutic management of medical issues of the upper urinary tract such as urolithiasis and urothelial tumors. The objective of this review is to describe its indications and results in the different scenarios for the treatment of urinary stones.

External validation and comparison of current scoring systems in retrograde intrarenal surgery: Multi‐institutional study with 949 patients

“…In parallel to the minimal invasive surgery trend in urological surgery, flexible ureterorenoscopy (f‐URS) and laser lithotripsy gained a significant popularity in the treatment of renal stones. Despite the technological advancements in optical and lithotripsy systems, there are still some limiting factors including stone burden and abnormal renal anatomy 1 . To standardize reporting the outcomes in scientific studies and pre‐operative counseling of patients some scoring systems were developed but none of them gained popularity and were not widely used.…”

Does extracorporeal shock wave lithotripsy before retrograde intrarenal surgery complicates the surgery for upper ureter stone? The results of the RIRSearch group

“…RIRS is an emerging surgical technique for the treatment of upper urinary system stone disease. Despite its invasive nature, the preference rate of RIRS has increased significantly 2 . Moreover, many urologists prefer ESWL as the first‐line treatment of proximal ureteral stone disease.…”

“…The evolutional history of retrograde intrarenal surgery (RIRS) dates back to the 1970s, but the clinical usage of this technique has gained increasing popularity in the last two decades 1 . The functional developments of flexible ureteroscopes, lasers and ancillary equipment have led RIRS to become a significant surgical technique for the treatment of upper urinary system stones 2 . Because of these technological advancements, the guidelines for the treatment of urinary system stone disease have been frequently revised.…”

“…ence rate of RIRS has increased significantly 2. Moreover, many urologists prefer ESWL as the first-line treatment of proximal ureteral Surgical outcomes and complications of retrograde intrarenal surgery in Group 1 and Group 2 The predictive effects of model variables on the surgical outcomes of patients who had extracorporeal shock wave lithotripsy (ESWL) before retrograde intrarenal surgery (RIRS)…”

Impact of case volume per year on flexible Ureteroscopy practice: an internet based survey

“…When asking about the use of a safety guidewire, 68% of group 1 and 60% of group 2 indicated that they used it in all cases. In the past, use of a safety guidewire was highly advised to allow smooth access to the pelvicalyceal system and facilitates ureteral stent placement in case of ureteral or collecting system injury [18]. A study by Western Endourological stone consortium showed that the risks for FURS damage were significantly decreased when using a safety guidewire [19].…”