Advances in laser technology and surgical telescopic systems have propelled retrograde intrarenal surgery (RIRS) to the forefront as a viable alternative to percutaneous nephrolithotomy (PCNL). Currently, RIRS is being increasingly utilized as a treatment option, even for kidney stones larger than 2 cm. In this narrative review, we aimed to take a snapshot of current practice in renal stone treatment and the latest technological and technical developments and to evaluate the efficacy of RIRS in larger renal stones. With low complication rates and acceptable stone-free rates, RIRS offers patients a less invasive option with favorable outcomes. There are insufficient data comparing PCNL with RIRS using a new-generation high-power laser and suctioning ureteral access sheath (UAS). Further studies with novel lasers and UAS could provide superiority in terms of RIRS. It is crucial to take into account various patient-specific considerations, such as stone location and burden, when deciding on the appropriate treatment approach.
Urology research & practice. 2023 Sep [Epub]
Senol Tonyali, Hakan Bahadir Haberal, Francesco Esperto, Zeeshan Hamid, Lazaros Tzelves, Amelia Pietropaolo, Esteban Emiliani
Department of Urology, Istanbul University Istanbul School of Medicine, Istanbul, Turkey; European Association of Urology, Young Academic Urologist, Urolithiasis and Endourology Working Group, Arnhem, Netherlands., Department of Urology, University of Health Sciences, Ankara Sanatorium Training and Research hospital, Ankara, Turkey., European Association of Urology, Young Academic Urologist, Urolithiasis and Endourology Working Group, Arnhem, Netherlands; Department of Urology, Campus Bio-Medico, University of Rome, Rome, Italy., European Association of Urology, Young Academic Urologist, Urolithiasis and Endourology Working Group, Arnhem, Netherlands; Department of Urology, Father Muller Medical College, Mangalore, India., European Association of Urology, Young Academic Urologist, Urolithiasis and Endourology Working Group, Arnhem, Netherlands; Department of Urology/Urooncology, University College of London Hospitals (UCLH), London, United Kingdom., European Association of Urology, Young Academic Urologist, Urolithiasis and Endourology Working Group, Arnhem, Netherlands; Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom., European Association of Urology, Young Academic Urologist, Urolithiasis and Endourology Working Group, Arnhem, Netherlands.