KUMJ | VOL. 24 | NO. 3 | ISSUE 96 | JULY-SEPTEMBER, 2026

Outcomes of Retrograde Intrarenal Surgery versus Mini- Percutaneous Nephrolithotomy for Renal Stones
Regmi P, Singh CK

Abstract:
Background Percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) are common minimally invasive procedures for the management of upper urinary tract stones. Objective To compare the efficacy and safety of percutaneous nephrolithotomy and, retrograde intrarenal surgery both using thulium fibre laser, in patients with solitary renal stones measuring 15–30 mm. Method This prospective comparative study carried out after ethical approval. A total seventyeight patients with single stone 1.5-3 cm in longest diameter were compared. The primary endpoint was stone-free rate at 4 weeks, assessed by kidney–ureter–bladder radiography and ultrasonography. Secondary outcomes included operative time, hospital stay, hemoglobin drop, transfusion requirement, and postoperative fever. Result A total seventy-eight patients with single stone 1.5-3 cm in longest diameter were included. Retrograde intrarenal surgery group (Group-A) had 41 patient and minipercutaneous nephrolithotomy group (Group-B) had 37 patients. RIRS demonstrated significantly shorter operative time (64.3 ± 23.1 vs. 79.4 ± 26.3 min; p = 0.01), reduced hospital stay (2.1 vs. 3.5 days; p = 0.001), and lower hemoglobin drop (1.33 ± 0.92 vs. 2.17 ± 1.30 g/dL; p = 0.002) compared with mini-percutaneous nephrolithotomy. Blood transfusion was required only in the mini-percutaneous nephrolithotomy group. Stone-free rate was similar in both groups (90.2% vs. 91.9%; p = 0.82). Postoperative fever rates were similar in both groups (4.9% vs. 2.7%; p = 0.58). Conclusion RIRS achieved comparable stone-free rates to mini-percutaneous nephrolithotomy group, with the advantages of shorter operative time, reduced hospital stay, and lower blood loss. Retrograde intrarenal surgery may represent a safe and effective minimally invasive alternative to mini-percutaneous nephrolithotomy in selected patients.
Keyword : Mini-percutaneous nephrolithotomy, Renal stone, Retrograde intra-renal surgery, Thulium laser lithotripsy