Comparison of retrograde intrarenal surgery and percutaneous nephrolithotomy in multiple calyceal stones: A match pair analysis of 190 cases

The current nephrolithia-sis guidelines have no recommendation about multiple calyceal stones treatment. We aimed to compare the results of two effective methods of RIRS and PNL operations in the treatment of multicalyx stones. Data of patients who underwent RIRS or PNL for multicalyx stones between September 2014 and May 2019 in our clinic were evaluated retrospectively. In both groups, stone-free and complication rates, hospital stay, scopy times, and operation times were examined. In RIRS group, the number of sessions and total stone-free rates at the end of each session were evaluated separately. A total of 162 patients in the RIRS group, and 103 patients in the PNL group were evaluated. After the match pair 1:1, data of 95 patients were selected in each group. Stone burden, number, density, ASA scores, BMI were similar in both groups. At the end of the first session RIRS, 59 (62.1%) patients became stone-free, while in the PNL group 73 (76.8%) patients (p: 0.027). The statistical analysis showed that the stone-free rates obtained in the second sessions in the RIRS group were similar to those of the PNL group. After a total of 124 sessions of RIRS, a stone-free rate of 81.1% was achieved by 1.3 sessions on average. At least two session of RIRS is as effective as PNL on multiple calyceal stones. Stage RIRS can be an alternative to PNL at multicalyceal renal stones.