Retrograde intra-renal surgery for stone extraction

Objective. To assess various clinical parameters affecting the efficacy and safety profile of retrograde intra-renal surgery (RIRS) for stone extraction. Material and methods. Between the years 2001 and 2003, 63 patients underwent RIRS in our department for renal calculi, including 25 who had stones ≥20mm in size. Results. Among the 63 patients who underwent the operation, 19 (30%) had infectious complications postoperatively. Although neither preoperative stenting nor stone burden were found to have any direct implication on postoperative course, a trend was seen as 64% of the infected patients had initially had large renal stones (≥20mm in diameter) and 59% had been preoperatively drained. Conclusions. RIRS is currently considered to be a safe standard retrograde endoscopic procedure for treating renal calculi. However, patients with stones ≥20 mm in diameter or multiple small calculi, especially in the presence of pre-existing tubes or following prior urinary tract infections, represent a subgroup of patients that are, in general, at higher risk of remarkable infectious complication rates and are likely to experience less satisfying stone-free rates when RIRS surgery is performed.