Introduction: Nephrolithiasis is one of the health concerns worldwide with the increasing prevalence and recurrence rates and the prevalence is ranging from 7% to 13% in North America, 5-9% in Europe, and 1-5% in Asia. Urinary stones are affecting approximately 12% of the world population of all ages, sex, and race. In this study, we evaluate of efficacy of retrograde intrarenal surgery (RIRS) combined with percutaneous nephrolithotomy (PCNL) in the treatment of kidney stones and compare its results with RIRS and PCNL monotherapy.
Methods: We analyzed 144 patients who underwent combined method (12.5%), RIRS (53.4%), and PCNL (36.1%) treatments between 2017 and 2018. The stone-free rates after one session at different treatments were following combined method (94.44%), RIRS (83.78%), and PCNL (78.85%). The mean duration of operation was 58.88±13.12 min in combined method, 55.94±26.50 min in the RIRS, and 67.01±29.39 min in the PCNL group (p<0.0277). Duration of hospitalization, intraoperative blood loss, blood transfusion hematuria and complication in the postoperative period were also evaluated.
Results: We found that the combined method had a higher stone-free rate, shorter length of stay. This could partially be explained by the minimal invasiveness, less trauma and high stone-free, which result in the complete evacuation of stones and fast recovery. Notably, most of the large, rigid, and complex stones were treated with the combined method. Although the combined treatment is a safe and effective method, the complication rate was slightly higher.