Purpose: The goal of this study was to analyze the effect of stone composition on the efficacy of retrograde intrarenal surgery (RIRS) with kidney stones of 1-3 cm, 1-2 cm, and 2-3 cm in diameter.
Methods: We undertook a retrospective analysis of 74 patients with kidney stones who underwent RIRS. The patients were divided into two groups based on stone composition: Group I (n=47) (calcium oxalate monohydrate and calcium phosphate) was the hard to fragment stone group and group II (n=27) (calcium oxalate dihydrate, magnesium ammonium phosphate, and uric acid) was the easy to fragment stone group. Forty-six patients with kidney stones 1 to 2 cm in diameter were divided into group A (n=30) (smaller than 20 mm, hard to fragment stones) and group B (n=16) (smaller than 20 mm, easy to fragment stones). Twenty-eight patients with stones 2 to 3 cm in diameter were divided into group C (n=17) (larger than 20 mm, hard to fragment stones) and group D (n=11) (larger than 20 mm, easy-to-crush stones).
Results: The stone clearance rates of group I and group II were 66.0% and 88.9%, respectively (P< 0.05). The stone clearance rates of group A and group B were 73.3% and 100% (P< 0.05). The stone clearance rates of group C and group D were 52.9% and 72.7%, respectively.
Conclusion: Stone composition has a significant impact on the efficacy of RIRS in the management of 1 to 3 cm kidney stones. For 2-3 cm calcium oxalate dihydrate stones, uric acid stones, and magnesium ammonium phosphate stones, the outcome of RIRS treatment was relatively good, and RIRS is recommended.
Written by:
Xue Y, Zhang P, Yang X, Chong T. Are you the author?
Department of Urology, The Second Affiliated Hospital of Xi'an Jiaoton University, Xi'an, China.
Reference: J Endourol. 2014 Dec 2. Epub ahead of print.
doi: 10.1089/end.2014.0778
PubMed Abstract
PMID: 25458448