title: Retrograde intrarenal surgery (RIRS) in the treatment of calyceal diverticulum with lithiasis.
abstract: OBJECTIVE
  To evaluate the result of retrograde intrarenal surgery (RIRS) assisted by flexible ureterorenoscopy (FURS) and Holmium laser in the treatment of lithiasis within calyceal diverticula as a minimally invasive therapeutic option.
  
  
  METHODS
  We retrospectively evaluated 11 cases of symptomatic lithiasis within calyceal diverticula treated between January 2010 and December 2011. We defined treatment success as absence of residual stones and absence/disappearance of symptomatology over the course of follow-up. We describe the RIRS technique and maneuvers for locating the diverticulum, opening the neck, and fragmenting intradiverticular lithiasis.
  
  
  RESULTS
  The most frequently experienced symptom was flank pain (72.7%). The size of the lithiasis treated ranged from 7-20 mm. The overall success rate of RIRS was approximately 73% (absence of lithiasis and disappearance of symptoms) with an average follow-up of 13.3 months. Three cases were not solved by RIRS (2 due to unsuccessful location of the neck, 1 due to persistence of lithiasis and symptoms) . Cases of unsuccessful location were treated with laparoscopic surgery.
  
  
  CONCLUSIONS
  RIRS assisted by FURS and Holmium laser is an effective and minimally invasive procedure for the treatment of lithiasis in the interior of the calyceal diverticulum. This treatment's efficacy improves upon the results from ESWL (extracorporeal shock wave lithotripsy( and equals that of the percutaneous method, exhibiting a lower rate of complications.
authors.affiliation: Unidad de Litotricia y Endourologia. Servicio de Urologia.Hospital Universitario La Ribera.Alzira. Valencia.Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Palmero
authors.forename: Jaume
authors.initials: J
authors.lastname: Miralles
authors.forename: Carmen
authors.initials: C
authors.lastname: Garau
authors.forename: Ines
authors.initials: I
authors.lastname: Nuño de la Rosa
authors.forename: Araceli
authors.initials: A
authors.lastname: Amoros
authors.forename: Antonio
authors.initials: A
authors.lastname: Benedicto
mesh_terms: D000328:Adult; D004240:Diverticulum / Q000150:complications / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery*; D007674:Kidney Diseases / Q000601:surgery*; D020347:Lithiasis / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged