[Retrograde Intrarenal Surgery: Analysis of Efficacy, Safety and Cost-Effectiveness of drug preparation].

Abstract

Introduction: Retrograde intrarenal surgery (RIRS) is the optimal treatment for kidney stones of 5-20 mm, but the success of the intervention depends on providing access through the ureter. Traditional preoperative stenting is accompanied by stent-associated symptoms that worsen patients quality of life.

Objective: Comprehensive assessment of the efficacy, safety feasibility of using Omnic Ocas for drug preparation of the ureter for RIRS.

Material and methods: A prospective single-center study of 58 patients divided into groups: receiving Omnic Ocas 0.4 mg/day (n=29) and prestenting group (n=29). Intra- and postoperative parameters were evaluated. Additionally, a systematic review of 10 RCTs (n=1624) was performed.

Results: In the local study, the frequency of successful ureteral access sheath installation was comparable between groups (87% vs 92%, p>0.05). The Omnic Ocas group showed significantly better pain scores (3.2+/-1.1 vs 5.9+/-1.6 points, p<0.001), need for analgesics and quality of life according to the USSQ questionnaire (22.5+/-5.7 vs 34.8+/-7.3 points, p<0.001). Systematic review confirmed the advantages of tamsulosin over no preparation and comparable efficacy with prestenting with better tolerability.

Conclusion: Drug preparation with Omnic Ocas is not inferior to prestenting in efficacy, but superior in tolerability and economic feasibility, being a preferred alternative.