You have accessJournal of UrologyCME1 May 2022MP14-11 PROPENSITY SCORE-MATCHED ANALYSIS COMPARING RETROGRADE INTRARENAL SURGERY WITH PERCUTANEOUS NEPHROLITHOTOMY IN ANOMALOUS KIDNEYS Ee Jean Lim, Jeremy Yuen-Chun Teoh, Khi Yung Fong, Esteban Emiliani, Nariman Gadzhiev, Dmitry Gorelov, Yiloren Tanidir, Fabio Sepulveda, Abdullah Al-Terki, Sanjay Khadgi, Abhay Mahajan, Deepak Ragoori, Govindarajan Ramalingam, Vaddi Chandra Mohan, Arvind Prakash Ganpule, Santosh Kumar, Daniele Castellani, Manoj Monga, Scoffone Cesare, Fabio Vicentini, Olivier Traxer, Bhaskar Kumar Somani, and Vineet Gauhar Ee Jean LimEe Jean Lim More articles by this author , Jeremy Yuen-Chun TeohJeremy Yuen-Chun Teoh More articles by this author , Khi Yung FongKhi Yung Fong More articles by this author , Esteban EmilianiEsteban Emiliani More articles by this author , Nariman GadzhievNariman Gadzhiev More articles by this author , Dmitry GorelovDmitry Gorelov More articles by this author , Yiloren TanidirYiloren Tanidir More articles by this author , Fabio SepulvedaFabio Sepulveda More articles by this author , Abdullah Al-TerkiAbdullah Al-Terki More articles by this author , Sanjay KhadgiSanjay Khadgi More articles by this author , Abhay MahajanAbhay Mahajan More articles by this author , Deepak RagooriDeepak Ragoori More articles by this author , Govindarajan RamalingamGovindarajan Ramalingam More articles by this author , Vaddi Chandra MohanVaddi Chandra Mohan More articles by this author , Arvind Prakash GanpuleArvind Prakash Ganpule More articles by this author , Santosh KumarSantosh Kumar More articles by this author , Daniele CastellaniDaniele Castellani More articles by this author , Manoj MongaManoj Monga More articles by this author , Scoffone CesareScoffone Cesare More articles by this author , Fabio VicentiniFabio Vicentini More articles by this author , Olivier TraxerOlivier Traxer More articles by this author , Bhaskar Kumar SomaniBhaskar Kumar Somani More articles by this author , and Vineet GauharVineet Gauhar More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002543.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Endourologic interventions for urolithiasis in patients with anomalous kidneys can be challenging, and comparisons between these interventions are not well studied. We aim to compare the safety, outcomes and complications of retrograde intrarenal surgery (RIRS) versus percutaneous nephrolithotomy (PCNL) in patients with urolithiasis in anomalous kidneys. METHODS: A propensity score-matched pair analysis (PSM) was performed on pooled patient data from 20 centers. 569 patients with anomalous kidneys (Horseshoe kidney(HSK), ectopic kidney, malrotated kidney) and urolithiasis who received either PCNL or RIRS as the primary modality of intervention from 2010 to 2020 were analyzed. Patients were matched based on calculated propensity scores by a regression model using age, sex, co-morbidities, stone size, and renal anomaly type as co-variates. Multivariate logistic regression of factors (mode of treatment [PCNL or RIRS], comorbidities, stone size) and their effects on outcomes of stone-free rate (SFR), need to abandon surgery due to intraoperative difficulty, postoperative hematuria and sepsis and were analyzed when applicable. RESULTS: After PSM, there were a total of 127 pairs in each group. Overall, PCNL conferred a higher SFR compared to RIRS (OR=3.69, 95%-CI=1.91-7.46, p<0.001), particularly in HSK (OR=3.33, 95%-CI=1.22-9.99, p=0.023), and ectopic kidneys (OR=18.10, 95%-CI=3.62-147.63, p=0.002), with no significant difference in malrotated kidneys. There was no significant difference in post-operative sepsis observed. Surgery was abandoned more often in RIRS than PCNL (6.3% vs 0%, p=0.014). Although PSM provides a robust analysis due to baseline differences in the unmatched cohorts, this study was limited by an inevitable degree of selection bias. CONCLUSIONS: While both modalities are safe and efficacious, PCNL yields better SFR than RIRS in patients with anomalous kidneys, with no difference in post-operative sepsis rates. Patients may benefit from personalised management best carried out in high volume endourology centers. Source of Funding: NA © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e236 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ee Jean Lim More articles by this author Jeremy Yuen-Chun Teoh More articles by this author Khi Yung Fong More articles by this author Esteban Emiliani More articles by this author Nariman Gadzhiev More articles by this author Dmitry Gorelov More articles by this author Yiloren Tanidir More articles by this author Fabio Sepulveda More articles by this author Abdullah Al-Terki More articles by this author Sanjay Khadgi More articles by this author Abhay Mahajan More articles by this author Deepak Ragoori More articles by this author Govindarajan Ramalingam More articles by this author Vaddi Chandra Mohan More articles by this author Arvind Prakash Ganpule More articles by this author Santosh Kumar More articles by this author Daniele Castellani More articles by this author Manoj Monga More articles by this author Scoffone Cesare More articles by this author Fabio Vicentini More articles by this author Olivier Traxer More articles by this author Bhaskar Kumar Somani More articles by this author Vineet Gauhar More articles by this author Expand All Advertisement PDF DownloadLoading ...