scholarly journals Outcome of Rirs for Renal Pelvic Stones 1.5 to 2.0 cm using Semi-Rigid Uretero-Renoscopy

2021 ◽  
Vol 2 (2) ◽  
pp. 73-76
Author(s):  
Harris Hassan Qureshi

Background Retrograde Intrarenal Surgery (RIRS) is among the recommended treatment modality for stones located in renal pelvis and is of less than 2 cm. Renal Stones with Hounsfield units more than 1000 have low stone free rate with ESWL. Objective To determine the outcome of retrograde intrarenal surgery using semirigid ureteroscope in fragmentation of renal pelvic stone. Methods Patients with 1.5-2.0 cm stone located in renal pelvis of more than 1000 HU who underwent retrograde intrarenal surgery as primary procedure at Sindh Institute of Urology And Transplantation were included. Stone fragmentation was achieved with holmium-yttrium aluminum garnet laser. Secondary procedure was performed if complete stone fragmentation was not achieved. Statistical analysis was performed by SPSS version 20. Result Total 82 patients with mean size of pelvic renal stones 1.7 ± 0.53 cm were included. The mean operating time was 32.1±12.9 mins. The stone clearance rate at six weeks after the first procedure was 79.3%. Minor complications including flank pain, fever and hematuria were reported. Conclusion Retrograde intrarenal surgery performed with semi rigid ureteroscope in renal pelvic stones of more than 1000 HU is a technically safe and effective procedure. Keywords: Retrograde intrarenal surgery; Pelvic stone; Flexible ureteroscopy and holmium laser.

2021 ◽  
Vol 8 (9) ◽  
pp. 2644
Author(s):  
Ershad Hussain Galeti ◽  
Saqib Shahab ◽  
Mriganka Deuri Bharali

Background: Several modalities are available for upper ureteric stone fragmentation. From them pneumatic and holmium: yttrium-aluminum-garnet lithotripsy has favourable outcomes. In this study we studied 50 patients who underwent ureteroscopic pneumatic lithotripsy or laser lithotripsy. This study aims to to compare the outcome of PL and LL in the management of upper ureteric calculi.Methods: This is a prospective, randomized study of 50 cases; 25 cases of TUL with pneumatic lithotripter and 25 cases of TUL with laser lithotripter over two years. The purpose of this study was to analyze the factors predicting the stone-free rate, assess the complications following PL and LL, and assess the need for a second procedure if retropulsion of calculi occurs.Results: Two groups were similar in age, gender, mean size of stones, retropulsion and complications. There was a statistical difference in terms of stone free rate in favour of LL group (p≤0.05) and mean operative time in favor of the PL group (p≤ 0.05). Conclusions: In conclusion, we found that both the PL and LL approaches were effective and safe for upper ureteric calculi, but the LL method had advantages, especially in stone free rate, over the PL treatment. Another advantage of the LL method was safe stone fragmentation in upper ureteral calculi due to lower retropulsion rate in contrast with the PL method.


PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2728 ◽  
Author(s):  
Jiaqiao Zhang ◽  
Chuou Xu ◽  
Deng He ◽  
Yuchao Lu ◽  
Henglong Hu ◽  
...  

Purpose To clarify the outcome of flexible ureteroscopy (fURS) for management of renal calculi without preoperative stenting. Methods A total of 171 patients who received 176 fURS procedures for unilateral renal stones were reviewed. All procedures were divided into two groups depending on whether they received ureteral stenting preoperatively. Baseline characteristics of patients, stone burden, operation time, stone-free rates, and complications were compared between both groups. Results Successful primary access to the renal pelvis was achieved in 104 of 114 (91.2%) patients without preoperative stenting, while all procedures with preoperative stenting (n = 62) were successfully performed. A total of 156 procedures were included for further data analysis (56 procedures in stenting group and 100 in non-stenting group). No significant differences was found regardless of a preoperative stent placement in terms of stone-free rate (73.2% with stenting vs. 71.0% without, P = 0.854), operative time (70.4 ± 32.8 with stenting vs. 70.2 ± 32.1 without, P = 0.969). Conclusions fURS for management of renal stone without preoperative ureteral stenting are associated with well outcome in short term follow-up. Our study may help patients and doctors to decide if an optional stent is placed or not.


2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Takashi Kawahara ◽  
Hiroki Ito ◽  
Hideyuki Terao ◽  
Takehiko Ogawa ◽  
Hiroji Uemura ◽  
...  

A 23-year-old female had bilateral ureteral stents placed due to bilateral renal stones and hydronephrosis. The bilateral ureteral stents were changed every 3 months. A kidney ureter bladder (KUB) film showed left encrustation along the ureteral stent thus necessitating removal; however, the ureteral stent could not be removed cystoscopically. The ureteral stent was, therefore, extracted using flexible ureteroscopy (URS) with a holmium (Ho): yttrium aluminum garnet (YAG) laser.


2019 ◽  
Vol 87 (1) ◽  
pp. 41-46
Author(s):  
Abdullah Erdoğan ◽  
Ercüment Keskin ◽  
Abdulsemet Altun

Purpose: Kidney stones are one of the most common urological problems. When deciding on the method of treatment for this common disease, the cost of the procedure should also be taken into consideration. Materials and methods: We performed a retrospective analysis of 55 patients who underwent percutaneous nephrolithotomy and 75 patients who underwent retrograde intrarenal surgery between January 2016 and November 2018. Until operative success was achieved, all additional surgical procedures, extracorporeal shock wave lithotripsy procedures, and interventional procedures required to resolve complications were recorded. Total cost was compared between the percutaneous nephrolithotomy and retrograde intrarenal surgery groups. Results: No significant difference was found between the percutaneous nephrolithotomy and retrograde intrarenal surgery groups in terms of gender, mean age, stone side, stone localization and stone surface area. The total cost of 55 patients that underwent percutaneous nephrolithotomy was calculated as US$14.766 after the first operation, and the total cost of 75 patients that underwent retrograde intrarenal surgery was determined to be US$46.627. The mean cost per patient was calculated US$320 ± US$186 for percutaneous nephrolithotomy and US$749 ± US$242 for retrograde intrarenal surgery (p < 0.001). Conclusions: Percutaneous nephrolithotomy is a lower-cost and successful method in the surgical treatment of 1–3 cm stones, but the serious complications involved in this operation should be kept in mind.


2021 ◽  
Vol 93 (3) ◽  
pp. 313-317
Author(s):  
Orazio Maugeri ◽  
Ettore Dalmasso ◽  
Dario Peretti ◽  
Fabio Venzano ◽  
Germano Chiapello ◽  
...  

Introduction: The purpose of this study is to report the stone free rate (SFR) and clinical complications in patients submitted to retrograde intrarenal surgery (RIRS). Materials and methods: A total of 571 procedures of upper urinary stones treated using flexible ureteroscopy and holmium laser lithotripsy from January 2014 to February 2020 have been analyzed. Overall SFR was evaluated after 3 months following the procedure by means of a non-contrast computed tomography. Success was considered as stone-free status or ≤ 0.4 cm fragments. Results: The overall SFR was 92.3% in group 1 (stone size: < 1 cm), 88.3% in group 2 (stone size: > 1 ≤ 2 cm), 56.7% in group 3 (stone size: 2-3 cm) and 69.6% in group 4 (multiple stones). Post-operative complications, according to the Clavien- Dindo (CD) classification system, were recorded in 32 (5.6%) procedures. The major complications recorded were: one case of subcapsular hematoma (SRH) associated with pulmonary embolism two days after the procedure (CD Grade IIIa) treated conservatively and one case of hemorrhagic shock 2 hour with multiple renal bleedings requiring urgent nephrectomy (CD Grade IVA). Conclusions: The RIRS is an effective and safe procedure with a high SFR significantly correlated with the stone size; at the same time, RIRS could be characterized by severe clinical complications that require rapid diagnosis and prompt treatment.


2021 ◽  
Vol 8 (19) ◽  
pp. 1347-1351
Author(s):  
Ashok Kumar Nayak ◽  
Sanjay Kumar Mahapatra ◽  
Braja Mohan Mishra ◽  
Dipti Ranjan Dhar ◽  
Biswajit Sahu

BACKGROUND We wanted to compare the outcomes of retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mini-PCNL) in treating lower pole (LP) renal stones with a diameter of < 2 cm in terms of safety, efficacy, and stonefree rate (SFR). METHODS In a retrospective analysis data of 39 patients who underwent mini-PCNL (N = 19) or RIRS (N = 20) for LP stones with a diameter of < 2 cm were reviewed between November 2018 and November 2020 at the Department of Urology in Veer Surendra Sai Institute of Medical Sciences and Research (VSSIMSAR), Odisha. The mean age, sex, stone size, operating time, complications, hospital stay, and SFR were compared between the groups. The success of the procedure was defined as the absence of residual stones or small residuals of size 3mm or less on computed tomography at 12 weeks postoperatively. RESULTS Significant differences were found in the hospital stay duration in hours (103.3 ± 11.7 vs. 145.2 ± 16.4, P < 0.028) between the RIRS and mini - PCNL groups. The mean operation time (in minutes) was also significantly different between the RIRS group (82.5 ± 3.44) and mini PCNL group (86.21 ± 5.90, P = 0.021). The stonefree rates in the postoperative period at three months (RIRS vs. mini - PCNL: 95 % vs. 94 %, P = 0.47) were not significantly different. CONCLUSIONS RIRS and mini-PCNL are both safe and effective methods for treating LP stones with a diameter of < 2 cm. RIRS can be considered as a less invasive alternative to PCNL for the treatment of LP stones of < 2 cm with reasonable SFR with shorter hospital stay. KEYWORDS Retrograde Intrarenal Surgery, Percutaneous Nephrolithotripsy, Lower Pole Kidney Stones, Miniaturized Percutaneous Nephrolithotomy


1969 ◽  
Vol 1 (3) ◽  
Author(s):  
Jingyang Guo

Objective: To observation on Poly- Flexible Ureteroscopy(FURS) retrograde intrarenal surgery (RIRS) combined with ultrasound guided all seeing needle Microperc to treatment of Lower Pole Renal Calculi larger than 2cm stone with infundibulopelvic angle(IPA)less than 60 degrees. Method: From January 2016 to January 2017, 63 patients with IPA angle less than 60 degrees in our hospital were treated with Poly-FURS retrograde intrarenal surgery combined with ultrasound guided all seeing needle Microperc, the patients stone sized more than 2 mm and located in the lower-pole calyx were retrospectively reviewed. Multiple stones were found in 37 cases and solitary stones in 26. Male patients used 70cm Poly-FURS, and the female 42cm.The clinical data including the operation time, the amount of bleeding, the stone free rate(SFR), the incidence of postoperative complications. Results: The operation time was 30~60min, mean 45min, FURS lithotripsy time was 20~35min, ultrasound guided all seeing needle puncture time was 3~5min, and lithotripsy time was 8~12min. 48 cases mainly lithotripsy with FURS and 15cases with micro-Percutaneous nephrolithotomy(micro-perc), 3 cases of fever as postoperative complications, 2 cases of pain; In non blood transfusion patients. The postoperative hospital stay was 2~3 days, with an average of 2 days. Postoperative residual stones were observed in 3 cases(SFR 95.2%) and treated with ESWL after 2 weeks. The stone clearance rate was 98.4% (62/63)after one month. Conclusion: The results of our study demonstrated that Poly- FURS retrograde intrarenal surgery combined with ultrasound guided all seeing needle Microperc had a significant effect on the success rate of lower Pole Renal Calculi larger than 2cm.


2018 ◽  
Vol 17 (12) ◽  
pp. e2659-e2660
Author(s):  
A.L. Barr ◽  
L.B. Dragos ◽  
P. Jones ◽  
O. Aboumarzouk ◽  
S.C. Latcu ◽  
...  

2018 ◽  
Vol 9 (4) ◽  
pp. 233-236 ◽  
Author(s):  
Amir Reza Abedi ◽  
Mohammad Reza Razzaghi ◽  
Farzad Allameh ◽  
Fereshte Aliakbari ◽  
Morteza FallahKarkan ◽  
...  

Introduction: Several different modalities are available for ureteral stone fragmentation. From them pneumatic and holmium: yttrium-aluminum-garnet (Ho: YAG) lithotripsy have supportive outcomes. In this study we studied 250 subjects who had ureteroscopic pneumatic lithotripsy (PL) or laser lithotripsy (LL). Methods: Two-hundred fifty patients with ureteral stones underwent ureteroscopic lithotripsy (115 subjects in the PL group, 135 subjects in the LL group) from August 2010 to April 2016. The purpose of this investigation was to evaluate stone-free rate (SFR), mean operation time (MOT), mean hospital stay (MHS), stone migration and complications. Results: Two groups were similar in age, gender, mean size of stones, side of stone, and complications. There was a statistical difference in terms of SFR, stone migration and MHS in favor of the LL group (P ≤ 0.05, P ≤ 0.05 respectively), and MOT in favor of the PL group (P ≤ 0.05). Conclusion: Both the PL and LL techniques were effective and safe for ureteral stones, however a slightly higher SFR was found in the LL group.


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