Retrograde Intrarenal Surgery in Treatment of Nephrolithiasis: Is a 100% Stone-Free Rate Achievable?

Abstract

By means of a standardized surgical approach and use of technical equipment of the newest generation, it is possible to achieve very high stone-free rates without compromising safety. This approach, however, necessitates use of considerable resources, both technical/surgical and financial.

Factors associated with postoperative pain after retrograde intrarenal surgery for kidney stones

“…Thus RIRS became a common endourologic procedure for the treatment of renal stones with high success rates. [1][2][3][4][5][6] The RIRS procedure can be considered as a safe method due to rarely occurence of major complications as classified according to Satava III or Clavien III-V criteria. [7,8] Only a limited number of studies so far have investigated the complications developed after RIRS, and they only presented some severe complications of the procedure.…”

“…[1][2][3][4][5][6] Retrograde intrarenal surgery can be considered as a quite safe method because major complications rarely occur after the procedure. [7] However, only a limited number of studies have investigated the complications after RIRS.…”

“…[7] However, only a limited number of studies have investigated the complications after RIRS. [3,5,6] Those publications mention some complications of their series, and a few of them focus on the procedural postoperative pain. We categorized intraoperative complications of RIRS by using modified Satava classification system for the first time [7] , but we did not evaluate the postoperative pain as a complication because it is rather subjective.…”

The S.T.O.N.E. Score: A new assessment tool to predict stone free rates in ureteroscopy from pre-operative radiological features

“…Furthermore, the presence of ureteral stents may obscure the presence of small stone fragments following URS (26). This pragmatic method of limiting postoperative imaging to questionable and complicated cases is commonly accepted and minimizes radiation and costs to the patient (9,27). Aggressive endoscopic inspection combined with high magnification fluoroscopy has shown high sensitivity and specificity in evaluating 0-4mm stones (9,27).…”

“…Stone free was defined as absent of stone fragments or fragments ≤ 2 mm post URS after rigorous endoscopic inspection and real time fluoroscopy with the capability of high magnification imaging (9). If combined endoscopic visualization and fluoroscopy was sub-optimal, a CT scan was obtained to confirm stone free status.…”