AUA 2017: A prospective randomized study evaluating safety and efficacy of bilateral simultaneous retrograde intrarenal surgery for endoscopic management of bilateral renal calculi

Boston, MA (UroToday.com) Patients with bilateral urolithiasis are often counseled on staged retrograde intrarenal surgery (RIRS) versus bilateral RIRS in the same setting. Urologists often prefer to perform a staged procedure given the perceived morbidity associated with bilateral surgery. In this moderated poster session, Dr. Hemendra Shah prospectively evaluated 56 patients with bilateral renal calculi who underwent bilateral simultaneous RIRS between June 2003 and May 2016.

The author’s study group was compared with 56 randomly selected patients who underwent unilateral RIRS for unilateral RIS at their institution. Each group had access sheaths placed for all cases and a 200-micron laser fiber was used for stone dusting and fragmentation. All patients had a double J ureteral stent placed at the conclusion of the procedure. Not surprisingly, the mean duration of surgery was significantly longer in the study group. Despite this, however, the duration of posteroperative catheterization, hospital stay, intra and postoperative complications were comparable in both groups of patients. Stone free rate was evaluated 2-6 weeks postoperatively by combination of x-ray and ultrasound of the kidney and it was 78.5% in the control group and 67.85% in the study group (p=0.436).

This study was awarded the best poster of the session. An important point was brought up that it would have increased the value of the study if the authors compared ureteral stent colic between the two groups of patients. In this study, bilateral simultaneous RIRS was found to be safe and effective in patients with bilateral renal calculi.

Presented By: Hemendra Shah, MD

Author(s): Hemendra Shah, Rashmi Shah

Affiliation: Mumbai, India

Written By: Roshan M. Patel for UroToday.com

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA