title: Is retrograde intrarenal surgery a viable treatment option for renal stones in patients with solitary kidney?
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of retrograde intrarenal surgery (RIRS) for stones up to 2 cm in diameter in patients with solitary kidney.
  
  
  METHODS
  From January 2008 to January 2013, we prospectively enrolled all consecutive patients with solitary kidney and renal stones. Plain abdominal computed tomography scan was performed preoperatively and 1 month after the procedure to assess the stone-free rates (SFR). Serum creatinine levels were detected preoperatively, at day 1 postoperatively, at 1 month postoperatively, and then every 6 months postoperatively.
  
  
  RESULTS
  During the study period, we prospectively enrolled a total of 29 patients. The mean age was 55.7 ± 12.3 years; the mean stone size was 1.3 ± 0.4 cm. The primary SFR was 72.4 %; the secondary SFR was 93.1 %. The mean number of procedures per patient was 1.24. The mean serum creatinine levels were 1.5 ± 0.6, 1.6 ± 0.7, 1.6 ± 0.6, and 1.7 ± 0.7 mg/dl preoperatively, at 1 day after RIRS, at 1 month after RIRS, and at 1 year after RIRS, respectively, without detection of any statistical difference (p = 0.76). Median follow-up time was 35.7 ± 19.3 (12-72) months, but that was available for only 18 patients. The mean serum creatinine level at the last follow-up was 1.7 ± 0.9 mg/dl. No major complications were recorded. Grade I complications occurred in eight patients (27.4 %).
  
  
  CONCLUSIONS
  RIRS is safe and effective in the treatment of renal stones in patients with solitary kidney, without worsening renal function.
authors.affiliation: Stone Center at Department of Urology, Humanitas Clinical and Research Center, Rozzano, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Giusti
authors.forename: S
authors.initials: S
authors.lastname: Proietti
authors.forename: L
authors.initials: L
authors.lastname: Cindolo
authors.forename: R
authors.initials: R
authors.lastname: Peschechera
authors.forename: G
authors.initials: G
authors.lastname: Sortino
authors.forename: F
authors.initials: F
authors.lastname: Berardinelli
authors.forename: G
authors.initials: G
authors.lastname: Taverna
mesh_terms: D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000379:methods*
chemical_list: D003404:Creatinine
references.citation: BJU Int. 2012 Sep;110(6):898-902
references.pmid: 22372915
references.citation: J Urol. 2009 Jan;181(1):154-60
references.pmid: 19013616
references.citation: J Endourol. 2012 Apr;26(4):336-41
references.pmid: 22004844
references.citation: Urol J. 2011 Fall;8(4):277-82
references.pmid: 22090045
references.citation: J Endourol. 1994 Feb;8(1):15-9
references.pmid: 8186777
references.citation: J Endourol. 2007 Feb;21(2):119-23
references.pmid: 17338606
references.citation: Nephron. 1998;78(1):1-8
references.pmid: 9453396
references.citation: J Endourol. 2008 Apr;22(4):615-21
references.pmid: 18324903
references.citation: Urology. 2013 Aug;82(2):290-4
references.pmid: 23759378
references.citation: J Urol. 1993 Jun;149(6):1576-85
references.pmid: 8501816
references.citation: J Urol. 2013 Feb;189(2):580-4
references.pmid: 22982421
references.citation: Urology. 2003 Mar;61(3):518-22; discussion 522
references.pmid: 12639636
references.citation: Urol Res. 2010 Aug;38(4):307-13
references.pmid: 20625891
references.citation: Urology. 2012 Dec;80(6):1198-202
references.pmid: 23206763
references.citation: J Urol. 1987 Jul;138(1):203-6
references.pmid: 3599212
references.citation: Scand J Urol Nephrol. 2002;36(5):363-7
references.pmid: 12487741
references.citation: Ann Surg. 2004 Aug;240(2):205-13
references.pmid: 15273542
references.citation: Eur Urol. 2007 Apr;51(4):899-906; discussion 906
references.pmid: 17095141
references.citation: J Urol. 1992 Sep;148(3 Pt 2):1011-4
references.pmid: 1507318
references.citation: J Endourol. 2012 Jan;26(1):52-7
references.pmid: 22003819
references.citation: J Endourol. 2004 Feb;18(1):33-6
references.pmid: 15006050
references.citation: J Urol. 2002 Jan;167(1):31-4
references.pmid: 11743269
references.citation: Urology. 2013 Nov;82(5):1013-6
references.pmid: 23958507
references.citation: J Urol. 1992 May;147(5):1226-30
references.pmid: 1569654