Retrograde Intrarenal Surgery vs. Miniaturised Percutaneous Nephrolithotomy to Treat Lower Pole Renal Stone < 2 cms Diameter in Western Part of Odisha

Author(s): Ashok Kumar Nayak1, Sanjay Kumar Mahapatra2, Braja Mohan Mishra3, Dipti Ranjan Dhar4 Biswajit Sahu5

We wanted to compare the outcomes of retrograde intrarenal surgery (RIRS) and
miniaturized percutaneous nephrolithotomy (mini-PCNL) in treating lower pole
(LP) renal stones with a diameter of < 2 cm in terms of safety, efficacy, and stonefree
rate (SFR).
In a retrospective analysis data of 39 patients who underwent mini-PCNL (N = 19)
or RIRS (N = 20) for LP stones with a diameter of < 2 cm were reviewed between
November 2018 and November 2020 at the Department of Urology in Veer
Surendra Sai Institute of Medical Sciences and Research (VSSIMSAR), Odisha. The
mean age, sex, stone size, operating time, complications, hospital stay, and SFR
were compared between the groups. The success of the procedure was defined
as the absence of residual stones or small residuals of size 3mm or less on
computed tomography at 12 weeks postoperatively.
Significant differences were found in the hospital stay duration in hours (103.3 ±
11.7 vs. 145.2 ± 16.4, P < 0.028) between the RIRS and mini - PCNL groups. The
mean operation time (in minutes) was also significantly different between the RIRS
group (82.5 ± 3.44) and mini PCNL group (86.21 ± 5.90, P = 0.021). The stonefree
rates in the postoperative period at three months (RIRS vs. mini - PCNL: 95
% vs. 94 %, P = 0.47) were not significantly different.
RIRS and mini-PCNL are both safe and effective methods for treating LP stones
with a diameter of < 2 cm. RIRS can be considered as a less invasive alternative
to PCNL for the treatment of LP stones of < 2 cm with reasonable SFR with shorter
hospital stay.