Publication:

Effectiveness of retrograde intrarenal surgery for upper ureteric and renal stones: a retrospective cohort study

Background Retrograde intrarenal surgery (RIRS) has become an increasingly preferred minimally invasive procedure for the management of upper ureteric and renal stones due to its favorable safety profile and high stone clearance rate. This study aimed to evaluate the effectiveness and perioperative outcomes of RIRS in patients with upper urinary tract calculi.

Methods This retrospective cohort study was conducted at the Department of Urology, Enam Medical College and Hospital, from July 2018 to January 2026. A total of 382 adult patients with upper ureteric or renal stones who underwent RIRS with holmium laser lithotripsy were included. Demographic characteristics, stone-related variables, intraoperative findings and postoperative outcomes were retrieved from hospital records and analyzed descriptively.

Results The mean age of the patients was 46.2±14.8 years and the mean BMI was 26.3±4.6 kg/m². Multiple-site stones were the most common (36.1%), followed by renal pelvic stones (30.8%). Preoperative DJ stenting was performed in 36.9% of patients. General anesthesia was used in 91.8% of procedures and the combined dusting and popcorning technique was the most frequently applied stone management method (56.8%). The stone-free rate (SFR) at 4 weeks was 92.5%. Mean laser activation and operative times were 37.5 and 69.3 minutes, respectively. The average postoperative hospital stay was 2.5 days, while 7.5% of patients required additional intervention.

Conclusions RIRS is an effective and safe minimally invasive treatment option for upper ureteric and renal stones, providing high SFRs with acceptable perioperative outcomes.