https://doi.org/10.4081/aiua.2024.12617

Efficacy of flexible ureterorenoscopy in treating multiple renal stones: a cohort study

Vol. 96 No. 3 (2024)
Submitted: April 29, 2024
Accepted: July 4, 2024
Published: October 2, 2024
Kidney stone, urinary tract, retrograde intrarenal surgery, ureterorenoscopy, nephrolithiasis
Abstract Views: 113
PDF: 42
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Sarwar Noori Mahmood
College of Medicine, University of Sulaimani, Sulaymaniyah; Mercy Medical City, Sulaymaniyah, Kurdistan, Iraq.
Rawa Bapir
Smart Health Tower, Sulaymaniyah; Department of Urology, Sulaymaniyah Teaching Hospital, Sulaymaniyah; Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan, Iraq.
Khoshbin Faeq Mustafa
Department of Urology, Sulaymaniyah Teaching Hospital, Sulaymaniyah, Kurdistan, Iraq.
Ahmed Mohammed Abdalqadir
Department of Urology, Sulaymaniyah Teaching Hospital, Sulaymaniyah, Kurdistan, Iraq.
Shakhawan Hama Amin Said
College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan, Iraq.
Nali H. Hama
College of Medicine, University of Sulaimani, Sulaymaniyah; Smart Health Tower, Sulaymaniyah, Kurdistan, Iraq.
Hiwa O. Abdullah
Smart Health Tower, Sulaymaniyah; Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan, Iraq.
Berun A. Abdalla
https://orcid.org/0000-0001-5638-4128
Smart Health Tower, Sulaymaniyah; Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan, Iraq.
Fahmi H. Kakamad
fahmi.hussein@univsul.edu.iq
College of Medicine, University of Sulaimani, Sulaymaniyah; Smart Health Tower, Sulaymaniyah; Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan, Iraq.

Introduction: While the efficacy of flexible ureterorenoscopy (URS) in managing solitary kidney stones (KSs) is widely acknowledged, its effectiveness in treating multiple stones has scarcely been investigated. This study aims to assess the effectiveness and safety of retrograde intrarenal surgery (RIRS) utilizing flexible URS and laser lithotripsy in the management of multiple KSs. 
Methods: This study was a single-group cohort study conducted on patients with multiple KSs who underwent treatment with RIRS using flexible URS and laser lithotripsy. Stone-free status was considered as the lack of residual stone fragments or any residual stone of any size. The first follow-up appointment was arranged 3-4 weeks following the procedure. If significant residual stones were present, patients underwent reintervention within 2-4 weeks.
Results: A total of 110 patients with multiple KSs were included. The mean stone burden was 27.5 ± 7.9 mm, and the mean duration of the operation was 54.9 ± 19.7 minutes. Seven cases (6.3%) experienced intraoperative complications, while postoperative complications were found in eight cases (7.3%). After four weeks, a stone-free rate (SFR) was documented in 80.9% of the cases, and this rate increased to 93.6% after three months. The SFR after three months was significant with Guy’s stone score (p < 0.001); however, it did not reach a significant level with any other parameters. 
Conclusions: The RIRS with flexible URS may be an effective and potentially safe procedure for treating multiple KSs. It may yield a favorable SFR with an acceptable complication rate.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Said SH, Al Kadum Hassan MA, Ali RH, Aghaways I, Kakamad FH, Mohammad KQ. Percutaneous nephrolithotomy; alarming variables for postoperative bleeding. Arab J Urol. 2017;15:24-29.
Bhatti Kamran Hassan, Bapir Rawa, Bhatti Waseem Sarwar, Muhammad Huda Muhaddien, Abdullah Hiwa O., Abdalla Berun Anwar, Efficacy of sexual intercosurse in the spontaneous passage of distal or intramural ureteral stones: a randomsized controlled trial. Ann Med Surg. 2023;85:5972-5976.
Guan F, Han W, Ni T, Zhao L, Li X, Zhang B, et al. Genetic polymorphisms of RGS14 and renal stone disease. Arch Med Res. 2021;52:332-8.
Safarinejad MR. Adult urolithiasis in a population-based study in Iran: prevalence, incidence, and associated risk factors. Urol Res. 2007;35:73-82.
Bhatti KH, Rawa Bapir, Nadeem Sohail, Gomha FS, Shaat AHA, Channa AA, et al. Occupational hazard in urolithiasis patients in Qatar:A single-center cross-sectional study. Arch Ital Urol Androl. 2024;96:12022.
Ferraro PM, Taylor EN, Gambaro G, Curhan GC. Vitamin D intake and the risk of incident kidney stones. J Urol. 2017;197:405-10.
Romero V, Akpinar H, Assimos DG. Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Rev Urol. 2010;12:e86.
Kumar A, Kumar N, Vasudeva P, Kumar Jha S, Kumar R, Singh H. A prospective, randomized comparison of shock wave lithotripsy, retrograde intrarenal surgery and miniperc for treatment of 1 to 2 cm radiolucent lower calyceal renal calculi: a single center experience. J Urol. 2015;193:160-4.
Aggarwal R, Srivastava A, Jain SK, Sud R, Singh R. Renal stones: a clinical review. EMJ Urol. 2017;5:98-103.
Khan SR, Pearle MS, Robertson WG, Gambaro G, Canales BK, Doizi S, et al. Kidney stones (Primer). Nat Rev Dis Primers. 2016;2:1.
Teichman JM. Acute renal colic from ureteral calculus. N Engl J Med. 2004;350:684-93.
Chung DY, Kang DH, Cho KS, Jeong WS, Jung HD, Kwon JK, et al. Comparison of stone-free rates following shock wave lithotripsy, percutaneous nephrolithotomy, and retrograde intrarenal surgery for treatment of renal stones: A systematic review and network meta-analysis. PloS One. 2019;14:e0211316.
Ucer O, Erbatu O, Albaz AC, Temeltas G, Gumus B, Muezzinoglu T. Comparison stone-free rate and effects on quality of life of percutaneous nephrolithotomy and retrograde intrarenal surgery for treatment of renal pelvis stone (2-4 cm): A prospective controlled study. Curr Urol. 2022;16:5-8.
Yanaral F, Ozgor F, Kucuktopcu O, Sarilar O, Ayranci A, Savun M, et al. Comparison of flexible ureterorenoscopy and mini percutaneous nephrolithotomy in the management of multiple renal calculi in 10-30 mm size. Urol J. 2019;16:326.
Tevis SE, Kennedy GD. Postoperative complications and implications on patient-centered outcomes. J Surg Res. 2013;181:106-13.
Kasap Y, Senel S, Uzun E, Polat ME, Koudonas A, Ozden C. Does surgical position affect infective complications in percutaneous nephrolithotomy?. Urolithiasis. 2022;50:765-71.
Saltirov, I., Petkova, K. (2020). Complications Related with PCNL and Their Management. In: Zeng, G., Sarica, K. (eds) Percutaneous Nephrolithotomy. Springer, Singapore.
Chandrasekera, S. (2021). Percutaneous Nephrolithotomy: Management of Complications. In: Ng, A.C.F., Wong, M.Y., Isotani, S. (eds) Practical Management of Urinary Stone. Springer, Singapore.
Breda A, Ogunyemi O, Leppert JT, Lam JS, Schulam PG. Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater—is this the new frontier? J Urol 2008;179:981-4.
Cakici M, Sari S, Ozok H, Karakoyunlu N, Hepsen E, Sagnak L, et al. Comparison of Retrograde Intrarenal Surgery and Percutaneous Nephrolithotomy in the Treatment of 2-3 cm Multicalyceal Kidney Stones. J Urol Surg. 2018;5:143-48.
Alazaby H, Khalil M, Omar R, Mohey A, Gharib T, Abo-Taleb A, et al. Outcome of retrograde flexible ureterorenoscopy and laser lithotripsy for treatment of multiple renal stones. Afr J Urol. 2018;24:146-51.
Ozgor F, Kucuktopcu O, Ucpinar B, Gurbuz ZG, Sarilar O, Berberoglu AY, et al. Is there a difference between presence of single stone and multiple stones in flexible ureterorenoscopy and laser lithotripsy for renal stone burden< 300mm 2? Int Braz J Urol. 2016;42:1168-77.
Demirbas A, Yazar VM, Ersoy E, Demir DO, Ozcan S, Karakan T, et al. Comparision of percutaneous nephrolithotomy and retrograde intrarenal surgery for the treatment of multicalyceal and multiple renal stones. Urol J. 2018;15:318-22.
Sercan SA, Selmi V, Caniklioğlu M, Gürel A, Fatih At, Işikay L. Our retrograde intrarenal surgery experience in the treatment of multi-caliceal and multiple kidney stones. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2020;22:406-10.
Karsiyakali N, Karabay E, Erkan E, Kadihasanoglu M. Evaluation of nephrolithometric scoring systems to predict outcomes of retrograde intrarenal surgery. Urol J. 2020;17:352-7.
Lim SH, Jeong BC, Seo SI, Jeon SS, Han DH. Treatment outcomes of retrograde intrarenal surgery for renal stones and predictive factors of stone-free. Korean J Urol. 2010;51:777.
Atis G, Culpan M, Pelit ES, Canakci C, Ulus I, Gunaydin B, et al. Comparison of percutaneous nephrolithotomy and retrograde intrarenal surgery in treating 20-40 mm renal stones. Urol J. 2017;14:2995-9.
Muhialdeen AS, Ahmed JO, Baba HO, Abdullah IY, Hassan HA, Najar KA, et al. Kscien’s List; A New Strategy to Discourage Predatory Journals and Publishers (Second Version). Barw Med J.2023;11:24-26.

How to Cite

Mahmood, S. N., Bapir, R., Mustafa, K. F., Abdalqadir, A. M., Said, S. H. A., Hama, N. H., Abdullah, H. O., Abdalla, B. A., & Kakamad, F. H. (2024). Efficacy of flexible ureterorenoscopy in treating multiple renal stones: a cohort study. Archivio Italiano Di Urologia E Andrologia, 96(3). https://doi.org/10.4081/aiua.2024.12617
Copyright (c) 2024 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.