Comparison Between Percutaneous Nephrolithotomy and Retrograde Flexible Nephrolithotripsy in Obese Patients with 2 - 4 cm Renal Stones

 Nowadays, because of remarkable advancements in retrograde intrarenal surgery (RIRS), modest attention toward this procedure as the second or alternative choice for renal stones treatment has been drawn.

 In the present study, we compared RIRS and percutaneous nephrolithotomy (PCNL) outcomes in treating obese patients with 2 - 4 cm renal stones.

 Eighty-two patients who underwent PCNL (n = 40) and RIRS (n = 42) between June 2015 and December 2018 at the Department of Urology of Sina Hospital were enrolled in our retrospective cohort study.

 After the first surgery session, stone-free rates for the RIRS group were 92.9% and for the PCNL group was 95% (P value = 0.52). The mean operation time for the RIRS and PCNL groups were 71.6 ± 11 and 93.3 ± 12.2, respectively (P < 0.001). The hospitalization stay for all of the PCNL group was more than 1 day (mean = 2.5 days); however, that for the majority of the RIRS group was less than 1 day (P < 0.001). The analgesic use in the RIRS group was significantly lower than in the PCNL group (9.0 ± 5.5, 61.8 ± 13.6, respectively; P < 0.001). The overall complication rates were higher in the RIRS group. However, none of them were statically significant (P > 0.05).

 According to satisfactory outcomes obtained in the RIRS groups, it can be concluded that RIRS can be applied as an alternative or even the first choice in obese patients with 2 - 4 cm renal stones.