title: Simultaneous retrograde intrarenal surgery for ipsilateral asymptomatic renal stones in patients with ureteroscopic symptomatic ureteral stone removal.
abstract: BACKGROUND
  Ipsilateral asymptomatic renal stone associated with symptomatic ureteral stone is not a rare event, and the recommended treatment policy was not declared clearly. This study was conducted to compare the outcomes of simultaneous retrograde intrarenal surgery (RIRS) and ureteroscopy to ureteroscopy alone for this clinical event.
  
  
  METHODS
  415 patients with symptomatic ureteral stone and ipsilateral asymptomatic renal stones were reviewed to obtain two match groups, who were treating with simultaneous modality (group A, N = 72), or ureteroscopy alone (group B, N = 72). Matching criteria were ureteral and renal stone side, duration and location, the presence of pre-stented. Perioperative and postoperative characteristics were compared between the two groups.
  
  
  RESULTS
  Mean stone burdens were similar between group A and B. Mean operative duration for group A and B were 72.4 ± 21.3 and 36.4 ± 10.2 min, respectively (P < 0.001). Mean hospital duration was 6.4 ± 2.9 and 5.3 ± 2.1 days in group A and B, respectively (P = 0.521). Ureteral SFR was 100% in each group. Renal SFR for RIRS was 86.1%. Complication rates in group A were higher (22.2% vs 13.9%), but the differences were not statistically significant (P = 0.358). In group A, complications were significantly less in pre-stented patients (3/25 vs 5/11, P = 0.04). Auxiliary treatment rate was significant higher in group B (69.4% vs 5.6%, P < 0.001) during follow-up (mean >18 months).
  
  
  CONCLUSIONS
  Simultaneous RIRS for ipsilateral asymptomatic renal stones in patients with ureteroscopic symptomatic ureteral stone removal can be performed safely and effectively. It promises a high SFR with lower auxiliary treatment rate, and does not lengthen hospital duration and increase complications.
authors.affiliation: Urology Department, Fifth Affiliated Hospital, Guangzhou Medical University, 621 Gangwan Road, Huangpu District, Guangzhou, Guangdong, 510700, China. dehuilai@hotmail.com.|Translational Medical Center, Minimally Invasive Technology and Product, Guangzhou Medical University, Guangzhou, Guangdong, China. dehuilai@hotmail.com.
authors.forename: Dehui
authors.initials: D
authors.lastname: Lai
authors.affiliation: Urology Department, Fifth Affiliated Hospital, Guangzhou Medical University, 621 Gangwan Road, Huangpu District, Guangzhou, Guangdong, 510700, China. 416406696@qq.com.
authors.forename: Meiling
authors.initials: M
authors.lastname: Chen
authors.affiliation: Urology Department, Fifth Affiliated Hospital, Guangzhou Medical University, 621 Gangwan Road, Huangpu District, Guangzhou, Guangdong, 510700, China. gdgzgywyHYZ@tom.com.
authors.forename: Yongzhong
authors.initials: Y
authors.lastname: He
authors.affiliation: Urology Department, Fifth Affiliated Hospital, Guangzhou Medical University, 621 Gangwan Road, Huangpu District, Guangzhou, Guangdong, 510700, China. 157773933@qq.com.|Translational Medical Center, Minimally Invasive Technology and Product, Guangzhou Medical University, Guangzhou, Guangdong, China. 157773933@qq.com.
authors.forename: Xun
authors.initials: X
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D015897:Comorbidity; D006801:Humans; D007669:Kidney Calculi / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome; D018666:Ureteroscopy / Q000706:statistics & numerical data*