title: Retrograde intrarenal surgery versus percutaneous lithotripsy to treat renal stones 2-3 cm in diameter.
abstract: OBJECTIVE
  Retrograde intrarenal surgery (RIRS) performed using a flexible ureterorenoscope marked the beginning of a new era in urology. Today, even staghorn stones are successfully treated via RIRS. The recommended treatment for larger stones is percutaneous nephrolithotomy (PNL). However, the question of whether PNL or RIRS should be the first-line treatment option for larger stones remains controversial. In this study, we contribute to the debate by comparing the success and complication rates of PNL and RIRS that were used to treat renal pelvis stones 2-3 cm in diameter.
  
  
  METHODS
  The medical records of 154 patients (74 PNL, 80 RIRS) were retrospectively evaluated. PNL patients were placed in Group 1 and RIRS patients in Group 2.
  
  
  RESULTS
  The complete stone-free rates were 95.5% in the PNL group and 80.6% in the RIRS group 1 month postoperatively (P = 0.061). The respective complication rates (evaluated using the Clavien system) were 13.5% and 8.8% (P = 0.520).
  
  
  CONCLUSIONS
  RIRS affords a comparable success rate, causes fewer complications than PNL, and seems to be a promising alternative to PNL when larger stones are to be treated. Prospective randomized controlled trials are needed to confirm these findings.
authors.affiliation: Department of Urology, Medical Faculty, Bozok University, Yozgat, Turkey.
authors.forename: Kursad
authors.initials: K
authors.lastname: Zengin
authors.affiliation: Department of Urology, Medical Faculty, Bozok University, Yozgat, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Tanik
authors.affiliation: Department of Urology, Ministry of Health, Diskapi Education and Research Hospital, Ankara, Turkey.
authors.forename: Nihat
authors.identifier: 0000-0002-6680-9860
authors.initials: N
authors.lastname: Karakoyunlu
authors.affiliation: Department of Urology, Ministry of Health, Numune Education and Research Hospital, Adana, Turkey.
authors.forename: Nevzat Can
authors.initials: NC
authors.lastname: Sener
authors.affiliation: Department of Urology, Medical Faculty, Bozok University, Yozgat, Turkey.
authors.forename: Sebahattin
authors.initials: S
authors.lastname: Albayrak
authors.affiliation: Department of Urology, Ministry of Health, Diskapi Education and Research Hospital, Ankara, Turkey.
authors.forename: Can
authors.initials: C
authors.lastname: Tuygun
authors.affiliation: Department of Urology, Medical Faculty, Bozok University, Yozgat, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Bakirtas
authors.affiliation: Department of Urology, Medical Faculty, Bozok University, Yozgat, Turkey.
authors.forename: M Abdurrahim
authors.initials: MA
authors.lastname: Imamoglu
authors.affiliation: Department of Urology, Medical Faculty, Bozok University, Yozgat, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Gurdal
mesh_terms: D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects* / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D018666:Ureteroscopy / Q000009:adverse effects / Q000379:methods*
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