Efficacy of Retrograde Intrarenal Surgery Combined with Super-Mini Percutaneous Nephrolithotomy versus that of Microchannel Percutaneous Nephrolithotomy in the Treatment of Complex Renal Stones.

Objective To evaluate the efficacy and safety of super-mini-percutaneous nephrolithotomy (SMP), retrograde intrarenal surgery(RIRS) for children with upper urinary tract calculus. Methods Clinical data of 85 children with upper urinary tract calculi treated by SMP or RIRS from April 2016 to June 2018 were retrospectively analyzed. Patients were divided into two groups according to operative method: group SMP and group RIRS. In group SMP: there were 38 male and 14 female patients; the mean age was(4.6±2.7)years; the mean stone size was (15.2±4.8)mm; 17cases in left side, and 35 cases in right side; multiple stones were found in 18 cases and single stone was found in 34 cases. In group RIRS: there were 18 male and 15 female patients; the mean age was(4.6±3.1)years; the mean stone size was (14.2±5.1)mm; 9 cases in left side, and 24 cases in right side; multiple stones were found in 11 cases and single stone was found in 22 cases. No statistical significance was found between the two groups in sex, age, stone size, stone side(left/right), percentage of multiple calculi(P>0.05). Patients were evaluated with KUB radiography or CT after 1 month. The overall stone-free rate and complications of the two groups were compared. Results Group RIRS compared to group SMP showed longer operative time [(74.2±31.8)min vs. (57.9±27. 8)min, P = 0.015], and hospital stay after operation [(4.8±2. 8)days vs.(3.1±1.3) days, P =0.003]. The overall stone-free rate was 90.4%(47/52) for group SMP, and 48.5%(16/33) for group RIRS(P<0.01). The re-treatment rate was significantly higher in group RIRS compared to group SMP[36.4%(12/33) vs. 1.9%(1/52), P<0.01]. The complication rate was 9.6(3/52) and 27.3%(9/33) for groups SMP and RIRS, respectively (P <0.05). Conclusions SMP was more effective than RIRS to obtain a better stone free rate, less complications and re-treatment rate in children with upper urinary tract renal calculus. Key words: Supper-mini percutaneous nephrolithotomy; Flexible ureteroscopy; Upper urinary tract calculus; Child

Kidney stones are one of the most common benign diseases in urology. As technology updates and iterates, more minimally invasive and laparoscopic surgeries with higher safety performance appear. This paper explores the effectiveness of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) in treating kidney stones, focusing on their effects on inflammatory responses and renal function. We conducted a retrospective analysis of 200 patients with kidney stones treated in our hospital between June 2019 and June 2023. 100 patients who underwent RIRS were included in the RIRS group. Another 100 patients who underwent PCNL treatment were included in the PCNL group. The intraoperative blood loss, operation duration, and hospitalization time of the two groups of patients were recorded and compared. The enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of inflammatory factors in the serum of the two groups of patients: [serum amyloid A (SAA), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (CRP)] and renal function index [blood urea nitrogen (BUN), creatinine (Scr) and serum cystatin (Cys-c)]. The two groups of patients were recorded separately: Postoperative complications and stone-free rate. Operation duration was longer for the RIRS group than the PCNL group, which exhibited significantly less intraoperative blood loss and shorter hospital stays (p < 0.05). Before surgery, there was no statistically significant difference in the serum levels of SAA, IL-6, and CRP between the two groups of patients (p > 0.05). On the first day after surgery, the serum SAA levels in both groups were lower than before surgery, IL-6 and CRP levels were higher than before surgery, and the serum levels of SAA, IL-6, and CRP in the RIRS group were significantly lower than those in the PCNL group. The difference was statistically significant (p < 0.05). Before surgery, there was no statistically significant difference in the serum BUN, Scr, and Cys-c levels between the two groups of patients (p > 0.05). On the first day after surgery, the serum BUN, Scr, and Cys-c levels of the two groups of patients were significantly higher than those before surgery. The serum BUN, Scr, and Cys-c levels of the RIRS group were significantly lower than those of the PCNL group, and the difference was statistically significant (p < 0.05). Both surgical methods have sound stone-clearing effects regarding long-term stone clearance rates 1 month and 3 months after surgery (p > 0.05). PCNL had a better stone clearance rate on the 2nd postoperative day (p < 0.05). The incidence of postoperative complications in the RIRS group was significantly lower than that in the PCNL group, and the difference was statistically significant (p < 0.05). For kidney stones ≤2 cm, PCNL showed higher stone clearance rates on the second postoperative day. However, RIRS and PCNL demonstrated adequate long-term stone clearance at 1 and 3 months post-surgery. Both surgical methods are safe and effective, and RIRS is safer than PCNL. Compared with PCNL, RIRS is a new method of kidney stone operation, which has less trauma to the patient's body and fewer complications after the operation, speeding up the recovery process of the patient.

Objectives To evaluate the safety and efficacy of retrograde intrarenal surgery (RIRS) in the treatment of kidney stone with a diameter of 2~4 cm and to compare its results with those of percutaneous nephrolithotomy(PCNL). Methods We retrospectively analyzed a total of 143 patients: 86 patients (53 males and 33 females) who underwent PCNL and 57 patients (37 males and 20 females) who underwent RIRS between October 2009 and October 2014. Results The mean duration of operation was (100.26±33.26) min in the RIRS group and (75.55±21.5) min in the PCNL group(P<0.001). The hospital stay was significantly shorter in the RIRS group[(1.56±0.8)d vs (4.57±2.1)d in the RIRS and PCNL group, respectively; P<0.001]. Stone–free rates after one stage was 66.6% and 91.8% in the RIRS and PCNL groups, respectively.The stone–free rate of the RIRS group increased to 87.7% after the second stage.Blood transfusions were required in two patients in the PCNL group.Complication rates were higher in the PCNL group. Conclusions This study revealed that RIRS can be an alternative to PCNL in the treatment of kidney stone with a diameter of 2~4cm, especially in patients with comorbidities. Key words: Kidney Calculi; Nephrostomy, Percutaneous

To compare the safety and effectiveness of super-mini-percutaneous nephrolithotomy (SMP) and retrograde intrarenal surgery (RIRS) for the treatment of 1-2 cm lower-pole renal calculi (LPC). An international multicentre, prospective, randomised, unblinded controlled study was conducted at 10 academic medical centres in China, India, and Turkey, between August 2015 and June 2017. In all, 160 consecutive patients with 1-2 cm LPC were randomised to receive SMP or RIRS. The primary endpoint was stone-free rate (SFR). Stone-free status was defined as no residual fragments of ≥0.3 cm on plain abdominal radiograph of the kidneys, ureters and bladder, and ultrasonography at 1-day and on computed tomography at 3-months after operation. Secondary endpoints included blood loss, operating time, postoperative pain scores, auxiliary procedures, complications, and hospital stay. Postoperative follow-up was scheduled at 3 months. Analysis was by intention-to-treat. The trial was registered at http://clinicaltrials.gov/ (NCT02519634). The two groups had similar baseline characteristics. The mean (sd) stone diameters were comparable between the groups, at 1.50 (0.29) cm for the SMP group vs 1.43 (0.34) cm for the RIRS group (P = 0.214). SMP achieved a significantly better 1-day and 3-month SFR than RIRS (1-day SFR 91.2% vs 71.2%, P = 0.001; 3-months SFR 93.8% vs 82.5%, P = 0.028). The auxiliary procedure rate was lower in the SMP group. RIRS was found to be superior with lower haemoglobin drop and less postoperative pain. Blood transfusion was not required in either group. There was no significant difference in operating time, hospital stay, and complication rates, between the groups. SMP was more effective than RIRS for treating 1-2 cm LPC in terms of a better SFR and lesser auxiliary procedure rate. The complications and hospital stay were comparable. RIRS has the advantage of less postoperative pain.

Objective To evaluate the safety and efficacy of retrograde intrarenal surgery(RIRS)and minimally invasive percutaneous nephrolithotripsy (MPCNL)for the pediatric renal calculi (≥1.5 cm). Methods In the retrospective study, 97 patients with renal calculi(≥1.5 cm) underwent operation which is conducted by the same operative team from March 2011 to March 2016 .Among them, 40 patients were treated with RIRS, including 29 male and 11 female patients. 57 patients were treated with minimally invasive percutaneous nephrolithotripsy, including 45 males and 12 female patients. The mean stone size was (1.9±0.4)cm (ranging 1.5-3.0 cm) in the RIRS group and (2.1±0.5)cm(ranging 1.5-3.5 cm) in the MPCNL group. In RIRS group, 3 stones were stag-horn calculi. The diameter in 44 stones was more than 1.5 cm. Among them, 33 stones located in the renal pelvis and upper middle calyces. 11 stones located in the lower calyces. Multiple stones were found in 30 cases and single stone was found in 10 cases. 7 cases had the history of unilateral urolithiasis. 3 cases had the positive results of urine culture before operation. In MPCNL group, 7 stones were stag-horn calculi. The diameter in 60 stones was more than 1.5 cm. Among them, 56 stones located in the renal pelvis and upper middle calyces. 4 stones located in the lower calyces. Multiple stones were found in 41 cases and single stone was found in 16 cases. 4 cases had the history of unilateral urolithiasis. 2 cases had the positive results of urine culture before operation. The mean stone size in MPCNL was larger, but the difference was not statistically significant (P>0.05). No statistical significance was found between the two groups in sex, age, preoperative urine, positive culture, patients with renal staghorn calculi, percentage of multiple calculi, stones in lower calyx and operation history of the same side(P>0.05). The urine white blood cells between the two groups were statistically significant (P<0.01), but the urine white blood cells in RIRS before placing double J stent had no significant difference with those in MPCNL. Results In RIRS group, The mean operative time was(90.2±17.8) minutes. The mean hemoglobin deficit was (7.9±7.9)g/L. The complication rate was 7.5%(3/40). The postoperative hospital stay was (5.0±2.3)days. The hospitalization cost was (42 994.1±9 747.8)yuan.Stone-free rates after one session was 72.5%(29/40). After second procedure, stone-free rates were up to 90.0%(36/40). In MPCNL group, the mean operative time was (77.8±15.6)min. The mean hemoglobin deficit was (10.0±7.1)g/L. The complication rate was 24.6%(14/57). The postoperative hospital stay was (8.0±2.5)days. The hospitalization cost was(24 626.3±6 324.7)yuan. The stone-free rate after one session was 82.5%(47/57). After second procedure, stone-free rates were up to 94.7%(54/57). In statistics, there was no significant difference in hemoglobin drop, the stone-free rate on one session and the final stone-free rates(P>0.05). But significant difference existed in operative time, complications rate, postoperative hospitalization time and hospitalization cost(P<0.05). Conclusion Both RIRS and MPCNL are feasible, safe and minimally invasive way to treat renal calculi(≥1.5 cm) in pediatric patients.The stone-free rates between the two groups are comparable. RIRS has an advantage in postoperative hospitalization time and postoperative complications. MPCNL takes the advantage of operation time, hospitalization cost and needn't routinely places the double-J ureteral stent. Key words: Flexible ureteroscopy; Percutaneous nephrolithotomy; Renal calculi; Children

Introduction: Nephrolithiasis is one of the health concerns worldwide with the increasing prevalence and recurrence rates and the prevalence is ranging from 7% to 13% in North America, 5-9% in Europe, and 1-5% in Asia. Urinary stones are affecting approximately 12% of the world population of all ages, sex, and race. In this study, we evaluate of efficacy of retrograde intrarenal surgery (RIRS) combined with percutaneous nephrolithotomy (PCNL) in the treatment of kidney stones and compare its results with RIRS and PCNL monotherapy. Methods: We analyzed 144 patients who underwent combined method (12.5%), RIRS (53.4%), and PCNL (36.1%) treatments between 2017 and 2018. The stone-free rates after one session at different treatments were following combined method (94.44%), RIRS (83.78%), and PCNL (78.85%). The mean duration of operation was 58.88±13.12 min in combined method, 55.94±26.50 min in the RIRS, and 67.01±29.39 min in the PCNL group (p<0.0277). Duration of hospitalization, intraoperative blood loss, blood transfusion hematuria and complication in the postoperative period were also evaluated. Results: We found that the combined method had a higher stone-free rate, shorter length of stay. This could partially be explained by the minimal invasiveness, less trauma and high stone-free, which result in the complete evacuation of stones and fast recovery. Notably, most of the large, rigid, and complex stones were treated with the combined method. Although the combined treatment is a safe and effective method, the complication rate was slightly higher.

Background: Limited data have explored the efficacy of super-mini percutaneous nephrolithotomy (SMP) and retrograde intrarenal surgery (RIRS) in managing ≤2 cm renal calculi. This study aims to comprehensively evaluate the safety and effectiveness of SMP compared with RIRS. Methods: This prospective cohort study investigated 210 patients with renal calculi (≤2 cm) undergoing SMP or RIRS, randomly recruited over 4 years. In total, 51.4% underwent SMP and 48.6% underwent RIRS. Results: The mean patient age was 31.3 ± 14.7 years; 56.7% were men, mean stone size of 1.3 ± 0.28 cm, and stone hardness of 1190.1 ± 352.83 Hounsfield units. Pearson's correlation indicated negative correlations for SMP with hospital stays (r = -0.138, p = 0.046), operating time (r = -0.519, p < 0.001), and stone-free rate (SFR) (r = -0.161, p = 0.020); and a positive correlation with a postoperative ureteral catheter (r = +0.389, p < 0.001). With regard to RIRS, the study shows a positive correlation with hospital stay (r = +0.138, p = 0.046), operating time (r = +0.519, p < 0.001), and SFR (r = +0.161, p = 0.020); and a negative correlation with postoperative ureteral catheter (r = -0.389, p < 0.001). Logistic regression, using SMP as the reference, RIRS was associated with β = +0.31, and 1.20 (95% confidence interval [CI], 1.14-1.27, p ≤ 0.001) risk of operation duration and β = +0.37, 1.44 (95% CI, 1.00-2.07, p = 0.047) risk of longer hospital stay. Conclusion: This study investigates the suitability of SMP and RIRS for treating renal calculi ≤2 cm. SMP demonstrated superior efficacy with significantly shorter operating times and reduced hospital stays, suggesting potential advantages for managing lower volume renal stones.

Background: The prevalence of urolithiasis has increased during the last decades and now affects approximately 9% of the adult population specially in developed countries. European Urology Guidelines recommend PCNL in stones larger than 2 cm in size and ESWL in stones smaller than 2 cm in size as the first treatment option. With advances in technology, new generation flexible ureteroscopes with safe and effective lithotripters such as holmium laser have been developed and RIRS became an important alternative in the treatment of large urinary stones.&#x0D; Objective: To evaluate the safety and efficacy of retrograde intrarenal surgery (RIRS) in the treatment of kidney stones and to compare its results with those of percutaneous nephrolithotomy (PCNL).&#x0D; Materials and Methods: We retrospectively analyzed a total of 50 patients ─ 27 patients (20 males and 7 females) who underwent PCNL and 23 patients (17 males and 6 females) who underwent RIRS between January 2015 and December 2017.&#x0D; Results: The mean duration of operation was 60.65 ± 23.56 minutes in the RIRS group and 50.55 ± 12.77 minutes in the PCNL group (p&lt;0.047). The hospital stay was significantly shorter in the RIRS group (2.21 ± 0.9 vs 5.29 ± 1.53 days in the RIRS and PCNL groups, respectively; p&lt;0.016). Stone-free rates after one session were 88.6% and 84.8% in the RIRS and PCNL groups respectively. Blood transfusions were required in five patients in the PCNL group. Complication rates were higher in the PCNL group.&#x0D; Conclusion: This study reveals that RIRS can be an alternative to PCNL in the treatment of kidney stone.&#x0D; J Enam Med Col 2019; 9(2): 84-89

Percutaneous Nephrolithotomy vs Retrograde Intrarenal Surgery for Large Renal Stones in Pediatric Patients: A Randomized Controlled Trial

Safety and efficacy of retrograde intrarenal surgery in primary and residual renal calculi in children

ObjectiveTo compare the effectiveness and safety of Super-Mini PCNL (SMP) and Retrograde Intrarenal Surgery (RIRS) in the management of renal calculi ≤ 2 cm.Patients and methodsA prospective, inter-institutional, observational study of patients presenting with renal calculi ≤ 2 cm. Patients underwent either SMP (Group 1) or RIRS (Group 2) and were performed by 2 experienced high-volume surgeons.ResultsBetween September 2018 and April 2019, 593 patients underwent PCNL and 239 patients had RIRS in two tertiary centers. Among them, 149 patients were included for the final analysis after propensity-score matching out of which 75 patients underwent SMP in one center and 74 patients underwent RIRS in the other. The stone-free rate (SFR) was statistically significantly higher in Group 1 on POD-1 (98.66% vs. 89.19%; p = 0.015), and was still higher in Group 1 on POD-30 (98.66% vs. 93.24%, p = 0.092) SFR on both POD-1 and POD-30 for lower pole calculi was higher in Group 1 (100 vs. 82.61%, p = 0.047 and 100 vs 92.61% p = 0.171). The mean (SD) operative time was significantly shorter in Group 1 at 36.43 min (14.07) vs 51.15 (17.95) mins (p < 0.0001). The mean hemoglobin drop was significantly less in Group 1 (0.31 vs 0.53 gm%; p = 0.020). There were more Clavien–Dindo complications in Group 2 (p = 0.021). The mean VAS pain score was significantly less in Group 2 at 6 and 12 h postoperatively (2.52 vs 3.67, 1.85 vs 2.40, respectively: p < 0.0001), whereas the mean VAS pain score was significantly less in Group 1 at 24 h postoperatively (0.31 vs 1.01, p < 0.0001). The mean hospital stay was significantly shorter in Group 1 (28.37 vs 45.70 h; p < 0.0001).ConclusionSMP has significantly lower operative times, complication rates, shorter hospital stay, with higher stone-free rates compared to RIRS. SMP is associated with more early post-operative pain though.

To evaluate the safety and efficacy of retrograde intrarenal surgery (RIRS) in the treatment of kidney stones greater than 2 cm and to compare its results with those of percutaneous nephrolithotomy (PCNL). We retrospectively analyzed a total of 143 patients: 86 patients (53 males and 33 females) who underwent PCNL and 57 patients (37 males and 20 females) who underwent RIRS between October 2009 and October 2013. The mean duration of operation was 100.26±33.26 min in the RIRS group and 75.55±21.5 min in the PCNL group (p<0.001). The hospital stay was significantly shorter in the RIRS group (1.56±0.8 vs. 4.57±2.1 days in the RIRS and PCNL groups, respectively; p<0.001). Stone-free rates after one session were 66.6% and 91.8% of the RIRS and PCNL groups, respectively. The stone-free rate of the RIRS group improved to 87.7% after the second session. Blood transfusions were required in two patients in the PCNL group. Complication rates were higher in the PCNL group. This study revealed that RIRS can be an alternative to PCNL in the treatment of kidney stones with a diameter of 2-4 cm especially in patients with comorbidities.

Background: Stone size is a key factor in the determination of the success of treatment modalities. Recently, there has been a great advancement in technology for minimally invasive management of urinary stones such as percutaneous nephrolithotomy, ureteroscopy, shockwave lithotripsy, and retrograde internal Surgery. Aim of the Study: to assess and compare the efficacy of retrograde intrarenal surgery (RIRS) in the treatment of kidney stones greater than 2 cm versus percutaneous nephrolithotomy (PCNL). Patients and methods: A retrospective analysis was carried out for a total of 118 patients, of which 46 patients underwent RIRS while 72 patients underwent PCNL between May 2013 and May 2017. Results: The mean duration of operation was 96.39±41.11 min in the RIRS group and 69.51±19.3 min in the PCNL group (p<0.001). Hospital stay was significantly shorter in the RIRS group (1.32±0.6 vs. 4.19±1.9 days) in the RIRS and PCNL groups respectively (p<0.001). Stone-free rates after one session were 67.4% and 90.3% of the RIRS and PCNL groups, respectively. Blood transfusions were required in two patients in the PCNL group. Complication rates were generally higher in the PCNL group. Conclusion: The present study concluded that RIRS can be a successful substitute to PCNL in the treatment of kidney stones with a diameter of 2–4 cm particularly in patients with comorbidities.

Background: Renal stones, particularly those between 2 cm and 3.5 cm in size, present a significant challenge in urology. Despite the availability of modern techniques, the optimal treatment for stones within this size range remains a contentious issue. Percutaneous Nephrolithotomy (PCNL) and Retrograde Intrarenal Surgery (RIRS) are two popular minimally invasive procedures used to treat renal stones. However, there is limited consensus on the superiority of one over the other in terms of clinical outcomes, complications, and patient satisfaction. Objective: To compare the clinical outcomes of PCNL and RIRS in the treatment of renal stones sized between 2 cm and 3.5 cm, specifically focusing on stone-free rate (SFR), complications, hospital stay, blood loss, the need for repeat procedures, and patient satisfaction. Method: This was a prospective, randomized study conducted from June 2024 TO December 2024 at CMH nephrology and urology department district peshawer, with 150 patients presenting with renal stones between 2 cm and 3.5 cm. The patients were randomly assigned to either the PCNL group (n = 75) or the RIRS group (n = 75). Preoperative imaging (CT or ultrasound) confirmed stone size. Patients with bilateral kidney stones, a history of previous kidney surgeries, or significant comorbidities were excluded. Clinical outcomes, including SFR, hospital stay, complications (postoperative fever, infection, stent-related symptoms), blood loss, and the need for repeat procedures, were analyzed. Patient satisfaction was also evaluated using a 1-10 scale. Result: The study found that PCNL had a significantly higher stone-free rate (95%) compared to RIRS (82%). The mean hospital stay for RIRS was shorter (1.56 ± 0.4 days) compared to PCNL (6.5 ± 1.2 days). While the incidence of postoperative postoperative infection was higher in the RIRS group (44% vs. 2.7%), blood loss was greater in the PCNL group (12% vs. 4%). The need for additional procedures was higher in the RIRS group, with 44% requiring further sessions, compared to just 2.7% in the PCNL group. Patient satisfaction was higher in the PCNL group (94.7%) compared to RIRS (77.3%). The treatment of renal stones larger than 2 cm and smaller than 3.5 cm remains controversial, and Percutaneous Nephrolithotomy (PCNL) and Retrograde Intrarenal Surgery (RIRS) are two popular treatment options. This study compares these two techniques in terms of clinical outcomes, including stone-free rate (SFR), complications, hospital stay, and patient satisfaction. This prospective study was conducted June 2024 TO December 2024 at CMH neprology and urology department district peshawer involving 150 patients with renal stones who were randomized into two treatment arms, PCNL and RIRS, with 75 patients in each arm. They critically evaluated the following parameters: SFR, duration of hospital stay, blood loss during surgery, complications, requirement for re-procedures, and patient satisfaction. The puncture access of the PCNL group was decided according to the Guy's Score classification. The stone-free rate was significantly higher in the PCNL group (95%) compared to the group treated with other methods (82%). The mean hospitalization time was shorter for RIRS (6.5 ± 1.2 vs. 1.56 ± 0.4 days). PostoperativePostoperative infective complications were seen more in the RIRS group (44%) along with the stent -related symptoms (34.6%) but had the least postoperative morbidity in the PCNL group (2.7% infection). Blood loss was greater for the PCNL group (12%) compared to the RIRS group (4%), but both groups had low requirements for blood transfusions (2.7% for PCNL and 1.3% for RIRS). Furthermore, RIRS required a greater proportion of repeat sessions (44%) for total stone clearance, especially in cases involving larger stones or increased stone density, whereas PCNL required fewer repeat procedures (2.7%). The patient satisfaction was excellent in the PCNL group (94.7%) and was slightly higher than in the RIRS group (77.3%). Conclusion: Both PCNL and RIRS are effective treatments for renal stones between 2 and 3.5 cm, with PCNL offering superior stone-free rates and greater patient satisfaction, particularly for stones with favorable anatomy. RIRS is a less invasive approach but may require multiple sessions for complete stone clearance and is associated with a higher incidence of postoperative postoperative complications. The choice of procedure should be individualized based on patient characteristics, stone features, and treatment preferences.

Objective: Overweight and obesity increased worldwide over four decades. In 2016, nearly 11% of men and 15% of women over 18 years old were obese. Obesity is accepted as a risk factor for renal stones. The relationship between obesity and urolithiasis is complicated. Various complications can occur during perioperative or postoperative follow-up in obese patients. Minimal invasive nature and high efficacy of Retrograde Intrarenal Surgery (RIRS) present itself as a safe and less morbid treatment option. In this study, we aimed to compare the efficacy and safety of RIRS in the treatment of kidney stones in different BMI levels. Material and Methods: Files of 552 patients who underwent RIRS for renal stones between January 2012 and December 2017 were reviewed. We classified patients according to the World Health Organisation classification. These three groups were compared for stone-free rate, complication rate, operative and fluoroscopy times and length of hospital stay. Results: The stone-free rate (SFR) of the study population was 80.8%. It was 81% for Group 1, 83.7% for Group 2 and 77.7% for Group 3. There was no statistically significant difference between the three groups among SFR (p=0.346). Clinical insignificant residual fragments (CIRF) status was also similar among the three groups (p=0.254). Complication rates between the three groups were statistically similar (p=0.416). Conclusion: In this study, we have shown that RIRS is a suitable option for all urolithiasis patients, even for obese individuals. Stone-free rates, length of hospital stay, operation time and complication rates in obese patients are similar with non-obese patients. Keywords: urolithiasis; obesity; laser lithotripsy