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Evaluation of the anatomical factors affecting the success of retrograde intrarenal surgery for isolated lower pole kidney stones


Studies which examine the factors affecting success rate in kidney stones located in the lower pole as well as the effects of infundibulopelvic angle (IPA) and infundibular length (IL) have been conducted with a small number of patients. We aimed to evaluate the cut-off points of IPA and IL parameters that effect the success of retrograde intrarenal surgery (RIRS) for isolated lower pole kidney stones. This retrospective study includes 168 patients who underwent primary RIRS due to isolated lower pole kidney stones in our clinic between January 2013 and May 2020. Pre-operative demographic data, medical history, physical examination, surgery duration as well as the post-operative hospitalization time of patients specifics were obtained. According to pre-operative computed tomography (CT), stone size, stone burden, stone density, number of stones (single and multiple), stone laterality, congenital kidney abnormality, the presence of solitary kidney, parameters of IPA and IL were measured and both included in the study. All patients were divided into two groups as the successful group and the unsuccessful group according to their post-operative success. These two groups were compared in terms of pre and post-operative data. Stone burden, IPA < 42.65°, and IL > 27.5 mm were specified as the independent risk factors for success of RIRS procedure. The patients for whom RIRS procedure is planned for lower pole kidney stones, stone burden, IPA, and IL should be taken into consideration to be able to predict success and it should be kept in mind that additional treatment may be required.

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The author(s) received no financial support for the research, authorship.

Author information




Conception and design: SS, ST; data acquisition: ST; data analysis and interpretation: YK, CO; drafting the manuscript: SS, ST; critical revision of the manuscript for scientific and factual content: CO; statistical analysis: YK; supervision: CO.

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Correspondence to Samet Senel.

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The present study protocol was reviewed and approved by the Institutional Review Board of ### Hospital (approval number: E2-21-110).

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Tastemur, S., Senel, S., Kizilkan, Y. et al. Evaluation of the anatomical factors affecting the success of retrograde intrarenal surgery for isolated lower pole kidney stones. Urolithiasis (2021).

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  • Anatomical factors
  • Lower pole
  • Nephrolithiasis
  • RIRS