title: Single-Stage Bilateral Versus Unilateral Retrograde Intrarenal Surgery for Management of Renal Stones: A Matched-Pair Analysis.
abstract: OBJECTIVE
  This study aimed to compare the effectiveness and safety of single-stage bilateral and unilateral retrograde intrarenal surgery (RIRS) for treatment of patients with renal stones.
  
  
  METHODS
  Patients undergoing single-stage bilateral RIRS for renal stones between January 2011 and April 2014 were retrospectively reviewed and matched to patients undergoing unilateral RIRS at a 1:1 ratio by the propensity score based on age, sex, body mass index, American Society of Anesthesiologists classification, stone burden, and stone location (involvement of the lower calix or not). Main outcome measures were stone-free rate per patient and per renal unit and RIRS-associated morbidity.
  
  
  RESULTS
  Of 60 patients treated by single-stage bilateral RIRS, 59 patients were matched with patients treated by unilateral RIRS. Stone-free rates per patient for bilateral RIRS and unilateral RIRS were 84.7% and 91.5%, respectively (P=0.255). Median operative time (100 vs 65 min, P<0.001) and postoperative hospitalization (2 vs 1 d, P=0.011) was significantly longer for bilateral RIRS than unilateral RIRS. Median changes in hematocrit (1.3% vs 1.0%, P=0.964) and serum creatinine level (3 vs 2 μmol/L, P=0.716) were similar between bilateral and unilateral RIRS. The overall complication rate was slightly higher with bilateral RIRS (11.9% vs 8.5%, P=0.542). No serious RIRS-associated morbidities occurred in either group.
  
  
  CONCLUSIONS
  Single-stage bilateral RIRS was as effective and safe as unilateral RIRS among propensity score-matched patients.
authors.affiliation: 1 Department of Urology, Changhai Hospital, Second Military Medical University , Shanghai, PR China .
authors.forename: Yonghan
authors.initials: Y
authors.lastname: Peng
authors.affiliation: 1 Department of Urology, Changhai Hospital, Second Military Medical University , Shanghai, PR China .
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.affiliation: 1 Department of Urology, Changhai Hospital, Second Military Medical University , Shanghai, PR China .
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: 2 Department of Health Statistics, Faculty of Health Service, Second Military Medical University , Shanghai, PR China .
authors.forename: Qi
authors.initials: Q
authors.lastname: Chen
authors.affiliation: 1 Department of Urology, Changhai Hospital, Second Military Medical University , Shanghai, PR China .
authors.forename: Min
authors.initials: M
authors.lastname: Liu
authors.affiliation: 1 Department of Urology, Changhai Hospital, Second Military Medical University , Shanghai, PR China .
authors.forename: Xiaolei
authors.initials: X
authors.lastname: Shi
authors.affiliation: 1 Department of Urology, Changhai Hospital, Second Military Medical University , Shanghai, PR China .
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Gao
authors.affiliation: 1 Department of Urology, Changhai Hospital, Second Military Medical University , Shanghai, PR China .
authors.forename: Yinghao
authors.initials: Y
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery*; D007669:Kidney Calculi / Q000601:surgery*; D008096:Lithotripsy / Q000009:adverse effects; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D017063:Outcome Assessment, Health Care; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome