Safety and efficacy of percutaneous nephrolithotripsy versus retrograde intrarenal surgery for obese patients with pelvic 1.5:3 cm renal stones.

Abstract

Background: Retrograde intrarenal surgery (RIRS) has recently made significant breakthroughs, drawing some attention to it as a secondary or alternative method of treating kidney stones.

Objectives: To compare the safety and efficacy of the percutaneous nephrolithotripsy (PCNL) in the prone position vs retrograde intrarenal surgery (RIRS) in surgical treatment of unilateral pelvic renal stones from 1.5 to 3 cm is size in adult obese patients with body mass index ⩾30.

Methods: This prospective randomized comparative study was done at Helwan University Hospital. It was conducted on 120 patients with unilateral pelvic renal stones from 1.5 to 3 cm in largest diameter who was admitted through duration to compare the two procedures' differences in terms of complications, analgesic use, hospital stay, operational time, and stone-free rates.

Results: There was no significant difference between the two groups as regard stone free rate and complications. Stone free rate was 91.1% in PCNL group while it was 84.5% in RIRS group (p-value = 0.314). The mean operative time for PCNL & RIRS groups was 96 ± 28.23 min and 119 ± 14.4 min, respectively (p-value = 0.026). Mean hospital stay was 3.16 ± 0.77 days in PCNL group while it was 1.19 ± 0.69 days in RIRS group (p-value < 0.001).

Conclusion: RIRS can be used as the first option in obese individuals with 1.5 to 3 cm renal stones is based on the satisfactory results attained in the RIRS groups.