Can Retrograde intrarenal surgery (RIRS) be recommended in the treatment of renal stones?
Carlo Del Boca, Laura Perucchini, Matteo Quarta, Fabrizio Russo, Mario Tonghini, Luigi Benecchi.
Division Of Urology, “Istituti Ospitalieri di Cremona” Cremona (Italy)
INTRODUCTION
The progressive improvement in technique together with advancements in ureterorenoscopes has been impressive. There is
a lack of data for RIRS and we preset a case series of large renal stones treated with RIRS.
MATERIAL AND METHODS
We retrospectively analyzed 4 consecutive patients with renal stones at least 1 cm in diameter treat with RIRS between
September 2011 and April 2012. Stone free rates was defined as fragments less than 3 mm on follow up imaging in the form
of ultrasound, KUB or CT. Rigid ureterorenoscopy was carried out under prophylactic antibiotic cover. Lithotripsy was
done by means of a Holmium-Laser.A6 F open ended ureteric access catheter or a 6F multilenght stent were left
postoperatively and removed the following day or 2 weeks later respectively.
RESULTS
Mean age was 54 (range 36 to 64). The mean stone burden was 17 mm (range 10 to 20), the stones were pielic in 3 cases
and upper calyceal in 1. One repeat ureterorenoscopies was carried out . 2 of 4 patients (50%) were stone free after RIRS
and the other 2 patients underwent extracorporal shockwave lithotripsy (ESWL).
DISCUSSION
Complication rate was recored in 1 patients for extravagination of uretheral mucosa, that was treated conservatively.
CONCLUSION
Ureterorenoscopy and lasertripsy for the treatment of renal calculi in association with ESWL permit an high success rates.