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Kim, Park, and Park: The Efficacy of Retrograde Intrarenal Surgery (RIRS) in the Management of Renal Stone Disease
Original Article
Endourology/Urolithiasis
Korean Journal of Urology

Korean Journal of Urology 2009; 50(8): 786-790.

Published online: 19 August 2009

DOI: https://doi.org/10.4111/kju.2009.50.8.786

The Efficacy of Retrograde Intrarenal Surgery (RIRS) in the Management of Renal Stone Disease

Jongwon Kim, Jinsung Park1, Hyungkeun Park

Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

1Department of Urology, Eulji University Hospital, Daejeon, Korea.

Correspondence to: Hyungkeun Park. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap2-dong, Songpa-gu, Seoul 138-736, Korea. TEL: 02-3010-3737, FAX: 02-477-8928, hkpark@amc.seoul.kr

Received 10 March 2009       Accepted 23 July 2009

Copyright © The Korean Urological Association, 2009

Abstract

Purpose

With recent technological advances, the indications for retrograde intrarenal surgery (RIRS) have gradually increased. We evaluated the efficacy and treatment outcomes of RIRS for the treatment of renal stones.

Materials and Methods

We retrospectively reviewed the medical records of 23 patients with renal stones (7 in the renal pelvis, 9 in the renal calyx, and 7 in the renal diverticulum) treated with RIRS from January 2001 to July 2008. Mean stone burden was 110 mm2 (range, 9.42-428.6 mm2), and all operations were performed under general anesthesia using a semi-rigid ureteroscope in 9 cases, a flexible ureteroscope in 11 cases, and both types simultaneously in 3 cases. The holmium:yttrium-aluminum-garnet (Ho: YAG) laser and the nitinol basket were used for stone fragmentation and retrieval. The patients were followed up postoperatively with KUB (21 cases) or nonenhanced computed tomography (CT; 2 cases). Success was defined as no visible stones on KUB or nonenhanced CT.

Results

The mean operating time was 93 minutes (range, 30-205 minutes) and the mean hospital stay was 3.7 days (range, 1-9 days). Of 23 patients, 16 (70%) experienced complete elimination of the stone after only a single intervention. After ancillary extracorporeal shock wave lithotripsy (ESWL), the success rate was increased to 74% (17/23). In the remaining 6 patients, residual stone findings were less than 3 mm and were followed up with X-ray.

Conclusions

RIRS is a feasible procedure for treating renal stone disease with minimal complications. The results of our study suggest that RIRS can be recommended as a primary modality in the management of renal stone disease in selected patients such as those with ESWL failure and renal diverticular stones.

Keywords: Ureteroscopes, Lithotripsy

Figures and Tables

Table 1
Characteristics of the patients
kju-50-786-i001

a: calculated by formula for surface area of ellipse (lengthxheight x3.14/4), b: stone burdens were calculated except 2 cases with multiple tiny renal stones

Table 2
Outcomes of retrograde intrarenal surgery
kju-50-786-i002

RIRS: retrograde intrarenal surgery, SR: success rate, ESWL: extracorporeal shock wave lithotripsy, a: calculated by formula for surface area of ellipse (lengthxheightx3.14/4), b: stone burdens were calculated except 2 cases with multiple tiny renal stones

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