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Retrograde intrarenal surgery (RIRS), regular and small sized percutaneous nephrolithotomy (PCNL) in daily practice: European Association of Urology Section of Urolithiasis (EULIS) Survey

Stefano Paolo Zanetti, Luca Boeri, Michele Catellani, Andrea Gallioli, Alberto Trinchieri, Kemal Sarica, Emanuele Montanari
  • Stefano Paolo Zanetti
    Ospedale San Paolo, Urological Department, Medical School University of Milan, Milan, Italy
  • Luca Boeri
    Ospedale San Paolo, Urological Department, Medical School University of Milan, Milan, Italy
  • Michele Catellani
    Ospedale San Paolo, Urological Department, Medical School University of Milan, Milan, Italy
  • Andrea Gallioli
    Ospedale San Paolo, Urological Department, Medical School University of Milan, Milan, Italy | andrea.gallioli@gmail.com
  • Alberto Trinchieri
    Ospedale Alessandro Manzoni Lecco, Urological Department, Lecco, Italy
  • Kemal Sarica
    Dr. Lutfi Kirdar Training and Research Hospital, Urological Department, Semsi Denizer Cad. E-5 Karayolu Cevizli Mevkii, 34890, Kartal/Istanbul, Turkey
  • Emanuele Montanari
    Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Urological Department, Medical School University of Milan, Milan, Italy

Abstract

Objective: A wide selection of both anterograde and retrograde mini-invasive procedures exist for stones’ treatment. The 2016 European Association of Urology (EAU) guidelines still don’t univocally define a best option. Our purpose is to give an overview on some European Stone Centers’ customs and to compare real life clinical practice with statements of opinion leaders and Guidelines. Materials and Methods: In 2015 we performed a survey in 3 step about the spread of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) techniques among EAU Section of Urolithiasis (EULIS) members. The 1st and 2nd steps dealt with the definition of EULIS urologist and department by collecting personal opinions about the endoscopic techniques. The third step was about clinical results. This paper presents data from the first two steps. Results: Ninety-one people answered. Out of them, 80% are European and 42% work in Centres fully dedicated to stone treatment. In particular, 50% of responders perform more than 80 RIRS/year, 25% more than 80 PCNL/year, 48% more than 100 extracorporeal shock wave lithotripsy (SWL)/year. RIRS is mainly used to treat stones < 2 cm both as primary treatment and after SWL failure. 73% don’t perform routine pre-stenting and 66% ordinarily use a ureteral sheath. Hospital stay for RIRS is 24h for 70% of responders. Regular PCNL is performed by 87% of the responders, MiniPCNL by 58%, Ultra-MiniPCNL by 23% and MicroPCNL by 28%. Pneumatic balloon dilation is the favourite dilation technique (49%). 37% of responders perform PCNL always in the supine position, 21% always in the prone one. Almost all the responders agree about using Mini, Ultra-Mini and MicroPCNL for 1-2 cm stones. Approximately 50% also use MiniPCNL for stones > 2 cm. Conclusion: our survey confirms the great heterogeneity existing in stones’ treatment techniques in daily practice.

Keywords

Kidney Calculi/surgery; Nephrolithotomy; Percutaneous; Retrograde intrarenal surgery; PCNL; RIRS.

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Submitted: 2016-07-12 10:55:19
Published: 2016-10-05 16:52:28
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Copyright (c) 2016 Stefano Paolo Zanetti, Luca Boeri, Michele Catellani, Andrea Gallioli, Alberto Trinchieri, Kemal Sarica, Emanuele Montanari

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