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Ureteroscopic retrograde intrarenal surgery after previous open renal stone surgery: initial experience

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Abstract

The management of renal calculi following previous open surgery represents a challenge for urologists. The aim of this study is to evaluate the outcomes and safety of ureteroscopic laser retrograde intrarenal surgery (RIRS) for renal calculi following prior open renal surgery. The charts of 53 patients who underwent RIRS for renal calculi following prior open surgery for urolithiasis were reviewed. Both flexible and semi-rigid ureteroscopes were utilized together with holmium: YAG laser for stone disintegration. Intravenous urography, computed tomography (CT) and ultrasound were used to evaluate the patient, perioperatively. Stone size ranged from 5 to 32 mm (mean 14.3 mm). The mean operative time was 86 min (20–130). The overall stone-free rate was 92.4%. The overall stone-free rates after one and two-procedures were 79.2% (42 cases) and 92.4% (49 cases), respectively. Four patients (7.5%) had larger residual fragments, 2 (3.8%) of them underwent SWL, and 2 (3.8%) cases were followed up conservatively. Major complications were reported in two patients (3.8%). Stone analysis revealed calcium oxalate in 39 patients, uric acid in 5, calcium phosphate in 4, struvite in 3, and cystine in 2 cases. Ureteroscopic retrograde intrarenal surgery for renal calculi following prior open renal surgery was a minimally invasive, safe procedure with a high success rate. It is a viable alternative for PNL in managing recurrent renal calculi efficiently.

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Abbreviations

CT:

Computed tomography

Holmium:YAG:

Holmium:yttrium aluminium garnet

IVU:

Intravenous urography

PNL:

Percutaneous nephrostolithotomy

RIRS:

Retrograde intrarenal surgery

SWL:

Extracorporeal shock wave lithotripsy

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Authors and Affiliations

  1. Urology Department, Assiut University Hospital, Assiut, 71516, Egypt

    Mahmoud M. Osman, Mohamed M. Gadelmoula, Ahmed S. Safwat & Mohamed A. Elgammal

  2. Urology Department, Sohag University Hospital, Sohag, Egypt

    Wael M. Gamal

  3. Urology Division, Surgery Department, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia

    Mohamed M. Gadelmoula

Authors
  1. Mahmoud M. Osman
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  2. Wael M. Gamal
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  3. Mohamed M. Gadelmoula
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  4. Ahmed S. Safwat
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  5. Mohamed A. Elgammal
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Correspondence to Mahmoud M. Osman.

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Osman, M.M., Gamal, W.M., Gadelmoula, M.M. et al. Ureteroscopic retrograde intrarenal surgery after previous open renal stone surgery: initial experience. Urol Res 40, 403–408 (2012). https://doi.org/10.1007/s00240-011-0435-1

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  • DOI: https://doi.org/10.1007/s00240-011-0435-1

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