SAFETY AND EFFICACY OF SEMI-RIGID URETEROSCOPE IN RETROGRADE INTRARENAL SURGERY FOR RENAL PELVIC STONES UPTO 2 CM

Abstract

Objectives: To determine the efficacy and safety of RIRS with rigid URS for renal pelvis stone  between 1 to 2cm.

Materials and Methods: This is a prospective observational case series of 48 patients who under  RIRS at Institute of Kidney Diseases, Peshawar during 1st January 2022 and 31st December The primary indication was single renal pelvic calculi of up to 2 cm diameter in patients with previously failed treatment modalities or as primary cases. Data was analysed regarding patient demographics, stone size, surgery time, complications and clearance rates within a 2 months follow-up period.

Results: Total of Forty-eight patients with 29 (60.4%) males and 19 (39.6%) females in a ratio of 1.5 to 1. The mean age was 38.7 ± 10.8 years (range: 19 – 60 years). Mean stone diameter was 15.3 ± 2.6 mm. Early postoperative complications included fever, haematuria and retained stones. There were 12 (25%) cases of postoperative fever who resolved without any major sequelae, and  11 (22.9%) cases of early postoperative haematuria of which 4 (8.3%) patients received blood transfusions. The overall clearance rate after fi rst RIRS was 87.5% (n = 42) with a P value of 0.01 and is clinically signifi cant. Six (12.5%) patients were found to have stone fragments retained.  The clearance rate after 2nd look RIRS was 95.83% (n = 46).

Conclusion: Retrograde intrarenal surgery using semi-rigid ureteroscope for renal pelvic stones  has favourable stone free rates and the results are comparable to percutaneous nephrolithotripsy. Complications requiring intervention are below ten percent and are non-fatal.