Lower Pole Stones Are Associated with Low Stone-Free Rates in Retrograde Intrarenal Surgery: A Myth or Fact? - A...

Area of Science:

• Urology
• Endourology
• Nephrolithiasis Management

Background:

• Conflicting literature exists on the efficacy of retrograde intrarenal surgery (RIRS) for lower pole kidney stones.
• This study addresses the debate by comparing RIRS outcomes for lower pole versus pelvic stones.

Purpose of the Study:

• To evaluate the effectiveness of RIRS in treating lower pole kidney stones.
• To compare RIRS outcomes for lower pole stones against pelvic stones using matched case-control groups.

Main Methods:

• Retrospective analysis of 491 patients undergoing RIRS.
• Matched case-control study comparing 159 lower pole stone patients (Group 1) with 159 pelvic stone patients (Group 2).
• Matching criteria included stone burden, density, preoperative stenting, and prior shock wave lithotripsy history. Stone-free status assessed by CT scan one month post-RIRS.

Main Results:

• Stone-free rates were similar: 79.2% for lower pole stones vs. 83.6% for pelvic stones (p=0.387).
• Perioperative and postoperative complication rates were comparable between groups.
• Median operation time was identical (60 min), but lower pole stones required significantly longer fluoroscopy times (26s vs 3s, p=0.013).

Conclusions:

• RIRS demonstrates comparable stone-free rates and complication profiles for both lower pole and pelvic kidney stones.
• Lower pole stones treated with RIRS necessitate longer fluoroscopy times.
• RIRS is an effective treatment option for lower pole kidney stones.