Complete Stone Clearance after Retrograde Intrarenal Surgery among Patients with Urolithiasis in a Tertiary Care Centre: A Descriptive Cross-sectional Study

JNMA J Nepal Med Assoc. 2022 Dec 1;60(256):1033-1036. doi: 10.31729/jnma.7785.

Abstract

Introduction: Retrograde intra-renal surgery using flexible scopes and laser energy is a newer alternative in stone disease treatment armamentarium. It is claimed to be superior to other modalities for stone clearance, complications and hospital stay. The aim of this study was to find out the prevalence of complete stone clearance after retrograde intra-renal surgery among patients with urolithiasis in a tertiary care centre.

Methods: This was a descriptive cross-sectional study conducted in the Department of Urology in a tertiary care centre from 15 June 2021 to 14 May 2022 including adult patients with stone size up to 15 mm. Ethical approval was obtained from the Institutional Review Committee (Reference number: IRC-PA-143/2077-78). Convenience sampling was done. The prevalence of complete stone clearance (no residual fragment >4 mm) was calculated. Point estimation and 95% confidence interval were calculated.

Results: Among 42 patients, 36 (85.71%) patients (75.1-96.3, 95% Confidence Interval) achieved complete stone clearance. The mean age was 40.26±14.05 (16-74) years and the stone size was 1.27±0.19 (0.9 -1.5) cm. Similarly, the mean operating time was 51.55±9.34 (40-85) minutes and the hospital stay was 1.33±0.52 (1-3) days. Grade 3 ureteric injury occurred in one case. Residual fragments were seen in 6 cases (14.29%). Sepsis occurred in 4 cases (11.11%).

Conclusions: The prevalence of complete stone clearance was similar among patients undergoing retrograde intra-renal surgery in our study when compared to other studies conducted in similar settings.

Keywords: laser; miniaturization; postoperative complications.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Humans
  • Kidney
  • Kidney Calculi* / surgery
  • Middle Aged
  • Tertiary Care Centers
  • Urolithiasis* / surgery