Retrograde Intrarenal Surgery and Percutaneous Nephrolithotomy for the Treatment of Renal Stones Greater Than 2 Cm

Abstract

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.