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The Efficacy and Safety of Radiation-Free Retrograde Intrarenal Surgery: A Prospective Multicenter-Based, Randomized, Controlled Trial

Significant innovative changes in the treatment of kidney stones have occurred in the last 30 years, including extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy, and retrograde intrarenal surgery (RIRS). Despite these changes, the essential goals of kidney stone management remain the same: maximize stone-free rate (SFR) and minimize surgery-related morbidity. Recently, RIRS has especially become popular in stone management for several reasons, including minimal invasiveness, patients’ early discharge, lower complication rates, and favorable success rates. In general, RIRS has been performed under fluoroscopy guidance. The radiation exposure during RIRS with the frequent use…

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 Retrograde intra renal surgery (RIRS) versus percutaneous nephrolithotomy (PNL) as a primary treatment for large renal stones: A prospective randomized controlled trial

Shock wave lithotripsy (SWL), PNL and RIRS are the main treatment modalities for renal stones. While PNL efficacy is hardly affected by the stone size, the stone free rates (SFRs) after SWL or RIRS are inversely proportional to stone size. The aim of management of renal stones is to achieve stone free status with the least number of interventions using with the least invasive method with minimal complications. Endourology (RIRS, PNL) had been introduced as an alternative for SWL because of the reduced need for multiple sessions and shorter time to achieve a stone-free status. RIRS can be used as an alternative to PNL for the management of renal stones sized 2–3 cm, with comparable stone free rates, less hospital stays, less pain score, less hemoglobin drops. but longer lithotripsy time.

Articles of Interest

Evaluating the Safety of Retrograde Intrarenal Surgery (RIRS): Intra- and Early Postoperative Complications in Patients Enrolled in the Global Multicentre Flexible Ureteroscopy Outcome Registry (FLEXOR)

Our analysis showed that RIRS has a good safety profile but bleeding requiring transfusions, ureteric injury, fever, and sepsis are still the most common complications despite advancements in technology.

Promising future for kidney stone treatment

Advancements in surgical techniques have significantly improved the way kidney stones are treated. Retrograde intrarenal surgery (RIRS) has emerged as one of the most effective methods for removing stones that are two centimeters or smaller. Unlike traditional open surgeries, RIRS is minimally invasive. It involves inserting a flexible tube called a ureteroscope through the natural urinary tract, avoiding the need for external incisions.

Results of retrograde intrarenal surgery in the treatment of renal stones greater than 2cm

RIRS is a valid alternative for the treatment of kidney stones ≥2cm for its high success rate and few complications if performed in specialized centers.

Retrograde intrarenal surgery for renal stones - Part 2

Retrograde intrarenal surgery (RIRS) has become an effective and safe treatment modality in the management of urinary system stone disease. Recent developments and innovations in the flexible ureterorenoscope and auxiliary equipment have made this procedure easier and more effective with increased success rates. RIRS can be used as a primary treatment in patients with renal stones smaller than 2 cm, prior unsuccessful shock wave lithotripsy, infundibular stenosis, renoureteral malformation, skeletal-muscular deformity, bleeding diathesis and obese patients

Retrograde intrarenal surgery: Past, present, and future

With the recent technological advancements in endourology, retrograde intrarenal surgery has become a more popular procedure for treatment of urolithiasis. Furthermore, since the introduction of new laser systems and advanced flexible ureteroscopy with miniaturized ureteroscopes, the treatment indications for retrograde intrarenal surgery have expanded to include not only larger renal stones of >2 cm but also upper urinary tract urothelial carcinoma, ureteral stricture, and idiopathic renal hematuria.

URS vs. RIRS: Understanding the Best Surgical Options for Kidney Stone Removal

URS: Primarily targets stones located in the ureter and lower part of the kidney. URS is most effective for stones that are stuck in the ureter or near the entrance to the bladder. RIRS: Focuses on stones located within the kidney itself. RIRS is designed for treating stones that are inaccessible or difficult to reach using other methods, such as those in the renal pelvis or calyces.