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International Journal of Urology Research

Vol. 6, Issue 1, Part A (2024)

Comparative analysis of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) for renal calculi ≥ 2 cm: A comprehensive review


Dr. Sanchit Gupta and Dr. Abdul Sabooh Rizvi


This review comprehensively compares Retrograde Intrarenal Surgery (RIRS) and Percutaneous Nephrolithotomy (PCNL) for managing renal calculi ≥ 2 cm. As minimally invasive techniques, both RIRS and PCNL are pivotal in treating large renal stones, yet each presents unique advantages and limitations. This paper meticulously evaluates the efficacy, safety, complications, patient outcomes, and healthcare resource utilization associated with these procedures, drawing from current clinical studies and meta-analyses. RIRS, characterized by its endoscopic approach via the ureter, offers the benefit of being less invasive with potentially shorter recovery times. However, its efficacy in completely removing larger stones is often debated, with higher rates of auxiliary procedures compared to PCNL. Conversely, PCNL, involving a direct percutaneous approach to access the kidney, is noted for its higher stone-free rates and effectiveness in managing larger and more complex stones. This procedure, however, tends to be associated with greater morbidity, longer hospital stays, and higher complication rates. Our analysis reveals that while PCNL generally achieves superior stone clearance, RIRS provides a viable alternative for specific patient groups, particularly those who may not tolerate the more invasive nature of PCNL. Complications such as bleeding, infection, and adjacent organ injury are more commonly reported in PCNL, whereas RIRS is associated with a higher likelihood of needing additional procedures to achieve complete stone clearance. Patient outcomes, including pain levels, recovery duration, and quality of life post-procedure, are critically assessed, along with healthcare resource utilization encompassing hospital stay lengths, costs, and the need for re-interventions. This review aims to furnish urologists and healthcare professionals with a detailed comparative analysis to inform clinical decision-making, ensuring optimal patient care tailored to individual clinical scenarios. By delineating the strengths and weaknesses of RIRS and PCNL, this paper contributes to a nuanced understanding of their roles in the effective management of large renal calculi.

Pages: 30-33  |  142 Views  50 Downloads

International Journal of Urology Research
How to cite this article:
Dr. Sanchit Gupta and Dr. Abdul Sabooh Rizvi. Comparative analysis of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) for renal calculi ≥ 2 cm: A comprehensive review. Int. J. Urol. Res. 2024;6(1):30-33. DOI: 10.33545/26646617.2024.v6.i1a.32