ISSN 2149-3235 | E-ISSN 2149-3057
Original Article
Prediction Of Stone-Free Status After Single Session Retrograde Intrarenal Surgery For Renal Stones
1 University of Health Sciences Turkiye Yuksek Ihtisas Training And Research Hospital, Clinic Of Urology, Ankara, Turkey  
Turk J Urol ; : -
DOI: 10.5152/tud.2018.88615
Key Words: Nephrolithiasis, intrarenal surgery, stone-free, stone location
Abstract

 

Objective: To determine the possible factors effecting stone-free status (SFS) after single session retrograde intrarenal surgery (RIRS) for renal stones.
Material and methods: We retrospectively analyzed the charts of consecutive patients who underwent RIRS. Unilateral procedures for single renal stones were included the study. The studied parameters included patient demographics, stone characteristics [size, volume, location and attenuation according to Hounsfield unit (HU)], operation time, presence of preoperative double-J stent (DJS), use of ureteral access sheath (UAS) and SFS.
 

 

Results: The study included 100 patients whom 43 were stone free and remaining 57 had residual stones. The mean age of patients was 47.2 ± 13.4 years. The mean stone size (largest dimension), stone attenuation and stone volume were 14.8 ± 5.8 mm, 1010 ± 416 HU and 983 ± 974 mm3, respectively. The mean operative time was 60.8 ± 24.2 minutes. Mean stone size, volume and HU were higher in RS group compared to SF group however this was not statistically significant, 15.2 ±6.1 versus 14.2 ± 5.3 mm, 1056 ± 1037 mm3 versus 780 ± 745 mm3 and 1061 ± 374 HU versus 942 ± 462 HU, respectively (p=0.490, p= 0.135 and p= 0.226). On multivariate regression analysis stone location and UAS use were found the significant predictors of SFS. Patients having lower pole stones are 2.25 times likely to have residual stones after RIRS compared to patient’s having stones at other localizations (p<0.001).
 

 

Conclusion: Stone volume could be a more reliable parameter than stone size in predicting RIRS success. Lower pole stone location and UAS use could be considered the most significant predictors of SFS after single session RIRS for single renal stones.

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