Retrograde intrarenal surgery (RIRS), regular and small sized percutaneous nephrolithotomy (PCNL) in daily practice: European Association of Urology Section of Urolithiasis (EULIS) Survey

Objective: A wide selection of both anterograde and retrograde mini-invasive procedures exist for stones’ treatment. The 2016 European Association of Urology (EAU) guidelines still don’t univocally define a best option. Our purpose is to give an overview on some European Stone Centers’ customs and to compare real life clinical practice with statements of opinion leaders and Guidelines. Materials and Methods: In 2015 we performed a survey in 3 step about the spread of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) techniques among EAU Section of Urolithiasis (EULIS) members. The 1st and 2nd steps dealt with the definition of EULIS urologist and department by collecting personal opinions about the endoscopic techniques. The third step was about clinical results. This paper presents data from the first two steps. Results: Ninety-one people answered. Out of them, 80% are European and 42% work in Centres fully dedicated to stone treatment. In particular, 50% of responders perform more than 80 RIRS/year, 25% more than 80 PCNL/year, 48% more than 100 extracorporeal shock wave lithotripsy (SWL)/year. RIRS is mainly used to treat stones < 2 cm both as primary treatment and after SWL failure. 73% don’t perform routine pre-stenting and 66% ordinarily use a ureteral sheath. Hospital stay for RIRS is 24h for 70% of responders. Regular PCNL is performed by 87% of the responders, MiniPCNL by 58%, Ultra-MiniPCNL by 23% and MicroPCNL by 28%. Pneumatic balloon dilation is the favourite dilation technique (49%). 37% of responders perform PCNL always in the supine position, 21% always in the prone one. Almost all the responders agree about using Mini, Ultra-Mini and MicroPCNL for 1-2 cm stones. Approximately 50% also use MiniPCNL for stones > 2 cm. Conclusion: our survey confirms the great heterogeneity existing in stones’ treatment techniques in daily practice.

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The discrepancy between European Association of Urology (EAU) guidelines and daily practice in the evaluation of nocturia: Results of a Dutch survey

European Urology Supplements ◽

10.1016/s1569-9056(18)31089-3 ◽

2018 ◽

Vol 17 (2) ◽

pp. e344-e345

Author(s):

M.S. Rahnama’i ◽

D. Vrijens ◽

T. Marcelissen

Keyword(s):

European Association ◽

Daily Practice ◽

European Association Of Urology

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Comparison of Retrograde Intrarenal Surgery and Micro-Percutaneous Nephrolithotomy for Kidney Stones: A Meta-Analysis

Urologia Internationalis ◽

10.1159/000506716 ◽

2020 ◽

pp. 1-7

Author(s):

Zhenhua Gu ◽

Yucheng Yang ◽

Rui Ding ◽

Meili Wang ◽

Jianming Pu ◽

...

Keyword(s):

Hospital Stay ◽

Percutaneous Nephrolithotomy ◽

Kidney Stones ◽

Operative Time ◽

Meta Analysis ◽

Length Of Hospital Stay ◽

Clinical Results ◽

Retrograde Intrarenal Surgery ◽

Alternative Approach ◽

Significant Difference

Background: Advances in micro-percutaneous nephrolithotomy (PCNL) for kidney stones have made it an alternative approach to the retrograde intrarenal surgery (RIRS) approach. Nevertheless, the superiority of micro-PCNL over RIRS is still under debate. The results are controversial. Objectives: The purpose of this study was to systematically evaluate the clinical results in patients presenting with kidney stones treated with micro-PCNL or RIRS. Methods: A literature search was done for electronic databases to identify researches that compared micro-PCNL and RIRS till December 2019. The clinical outcome included complications, stone-free rates (SFRs), hemoglobin reduction, length of hospital stay, and operative time. Results: Five articles were included in our study. The pooled results revealed no statistical difference in the rate of complications (OR = 0.99, 95% CI = 0.57–1.74, p = 0.99), length of hospital stay (MD = −0.29, 95% CI = −0.82 to 0.24, p = 0.28), and operative time (MD = −6.63, 95% CI = −27.34 to 14.08, p = 0.53) between the 2 groups. However, significant difference was present in hemoglobin reduction (MD = −0.43, 95% CI = −0.55 to 0.30, p < 0.001) and the SFRs (OR = 0.59, 95% CI = 0.36–0.98, p = 0.04) when comparing RIRS with micro-PCNL. Conclusions: Compared with micro-PCNL to treat kidney stones, RIRS is associated with better stone clearance and bearing higher hemoglobin loss. As the advantages of both technologies have been shown in some fields, the continuation of well-designed clinical trials may be necessary.

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Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd007044.pub3 ◽

2014 ◽

Cited By ~ 31

Author(s):

Attasit Srisubat ◽

Somkiat Potisat ◽

Bannakij Lojanapiwat ◽

Vasun Setthawong ◽

Malinee Laopaiboon

Keyword(s):

Shock Wave ◽

Percutaneous Nephrolithotomy ◽

Kidney Stones ◽

Extracorporeal Shock Wave Lithotripsy ◽

Shock Wave Lithotripsy ◽

Retrograde Intrarenal Surgery ◽

Extracorporeal Shock Wave

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Percutaneous nephrolithotomy versus flexible ureteroscopy in terms of cost-effectiveness in patients with 10–30 mm renal stones

Urologia Journal ◽

10.1177/0391560319876805 ◽

2019 ◽

Vol 87 (1) ◽

pp. 41-46

Author(s):

Abdullah Erdoğan ◽

Ercüment Keskin ◽

Abdulsemet Altun

Keyword(s):

Percutaneous Nephrolithotomy ◽

Renal Stones ◽

Flexible Ureteroscopy ◽

Common Disease ◽

Retrograde Intrarenal Surgery ◽

Total Cost ◽

Extracorporeal Shock Wave ◽

Significant Difference ◽

The Cost ◽

Mean Cost

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.

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