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Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...

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A Randomized Study Comparing Mini PCNL and RIRS for Renal Stones between 8 mm and 15 mm - A Single Institutional

K M Chavannavar1, Tg Subash Kaushik, V Meyyappan

  • 1Department of Urology and Renal Transplantation, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India.

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|May 6, 2025
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Summary

Retrograde intrarenal surgery (RIRS) and mini percutaneous nephrolithotomy (mPCNL) offer high stone clearance for kidney stones. Surgeon discretion is advised, balancing operative time and complications for optimal patient outcomes.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery

Background:

  • Renal stone disease management requires advanced minimally invasive techniques.
  • Retrograde intrarenal surgery (RIRS) and mini percutaneous nephrolithotomy (mPCNL) are key for intermediate-sized renal stones (8-15 mm).

Purpose of the Study:

  • Compare RIRS and mPCNL for intermediate renal stones.
  • Evaluate stone clearance, operative metrics, complications, and patient outcomes.

Main Methods:

  • Randomized controlled trial comparing RIRS and mPCNL.
  • Primary outcome: stone clearance rate.
  • Secondary outcomes: operative time, complications, pain, re-intervention rates.

Main Results:

  • Comparable stone size (approx. 11.2 mm) in both groups.
  • Higher stone-free rates for mPCNL (96%) vs. RIRS (90%) at one month.
  • RIRS had shorter fluoroscopy time; mPCNL had higher complication rates and longer hospital stays.

Conclusions:

  • Both RIRS and mPCNL demonstrate high efficacy for intermediate renal stones.
  • RIRS shows advantages in operative time and fluoroscopy, while mPCNL has higher complication risks.
  • Treatment selection should be individualized by the operating surgeon based on patient factors.