RETROGRADE INTRARENAL SURGERY (RIRS): OUR SURGERY EXPERIENCE AND CLINICAL RESULTS

Abstract

INTRODUCTION: Urinary system stone diseases are common in our country and in the world. The flexibleureterorenoscope (flex URS) was first described by Marshall in 1964 and took its place in the guidelines as a surgical technique in 1987 with the advancing technology. r. Its indications are expanding rapidly. In this study, the data of patients who underwent retrograde intrarenal surgery (RIRS) in our clinic were evaluated retrospectively. MATERIALS AND METHODS: Demographic data, stone sizes, localizations, fluoroscopy duration, stone-free rates and postoperative complications of 106 patients who underwent RIRS in the urology clinic of Süleyman Demirel University Faculty of Medicine (SDU) between March 2017 and January 2019 were evaluated retrospectively. After the procedure, all patients were evaluated with DUSG and CT imaging methods 4 weeks later. RESULTS: The median age of 106 patients (66 males, 40 females) who underwent RIRS was 52 (23-73 years) and the mean stone size was calculated as 13.9 (7-19) mm. The mean duration of operation and fluoroscopy were respectively;74 (30- 135 minutes is 62 (20-136) seconds. None of the patients had a DJ catheter before the procedure, but a DJ catheter was placed in all patients at the end of the procedure and the catheter was removed under local anesthesia 4 weeks later. A second session was performed in 11 (10.3%) cases due to ureteral stenosis and in 8 (7.5%) cases because of residual stones. calyx, 40 (37.7%) lower calyx, 38 (35.8%) cases were found in the renal pelvis. It was found that 82.1% of our patients were stone-free in the first session. After the second session, the stone-free rate was 92.5%. CONCLUSION: RIRS is a reliable method in terms of efficacy and complications in stone surgery. It is an important surgical alternative especially in ESWL resistant stones, obese patients with musculoskeletal deformities, solitary kidney stones, pregnancy and bleeding diathesis. Considering the advantages of the technique together with the technological advances, we think that it will be used more actively and become widespread in the future.