Retrograde Intrarenal Surgery for the Treatment of Renal Stones in Patients With a Solitary Kidney

OBJECTIVE To evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) in the treatment of renal stones in patients with a solitary kidney. MATERIALS AND METHODS From December 2008 to March 2012, 24 patients with a solitary kidney who were treated with RIRS for renal stones were included in the study. All patients were preoperatively evaluated with urine culture, serum biochemistry, urinary ultrasonography, noncontrast computed tomography or intravenous urography, or both. The procedure was considered as successful in patients with complete stone disappearance or fragments <4 mm on computed tomography. Preoperative, operative, and postoperative data of the patients were retrospectively analyzed. The mean serum creatinine levels before and after the procedures were compared using a paired sample t-test. RESULTS The study included 24 patients with a mean age of 44.41 +/- 12.15 years (range, 24-70). The mean stone size was 19.83 +/- 5.90 mm (range, 10-35). The mean operative time was 55.83 +/- 10.90 minutes (range, 40-75). The success rates were 83.3% and 95.8% after the first and second procedures, respectively. A pigtail stent was placed in all patients. The mean serum creatinine levels before the procedures and at 2 weeks after removal of the pigtail stents were 1.54 +/- 0.55 mg/dL (range, 0.7-2.8) and 1.56 +/- 0.50 mg/dL (range, 0.9-2.6), respectively (P = .92). Minor complications, classified as Clavien I or II, occurred in 4 patients (16.6%). No major complications (Clavien III-V) occurred in the study group. CONCLUSION RIRS is an effective and safe procedure that can be used to manage renal stones in patients with a solitary kidney. UROLOGY 82: 290-294, 2013. (C) 2013 Elsevier Inc.