title: Intrarenal Surgery vs Percutaneous Nephrolithotomy in the Management of Lower Pole Stones Greater than 2 cm.
abstract: OBJECTIVE
  To compare the efficacy of RIRS and PNL in lower pole stones ≥ 2 cm. Materials and and Methods: A total of 109 patients who underwent PNL or RIRS for solitary lower pole stone between April 2009 and December 2012, were retrospectively analyzed. Lower pole stone was diagnosed with CT scan. Stone size was assessed as the longest axis of the stone. All patients were informed about the advantages, disadvantages and probable complications of both PNL and RIRS before the selection of the procedure. Patients decided the surgery type by themselves without being under any influences and written informed consent was obtained from all patients prior to the surgery. Patients were divided into two groups according to the patients' preference of surgery type. Group 1 consisted of 77 patients who underwent PNL and Group 2 consisted of 32 patients treated with RIRS. Stone free statuses, postoperative complications, operative time and hospitalization time were compared in both groups.
  
  
  RESULTS
  There was no statistical significance between the two groups in mean age, stone size, stone laterality, mean follow-up periods and mean operative times. In PNL group, stone-free rate was 96.1% at first session and 100% after the additional procedure. In Group 2, stone-free rate was 90.6% at the first procedure and 100% after the additional procedure. The final stone-free rates and operative times were similar in both groups.
  
  
  CONCLUSIONS
  RIRS should be an effective treatment alternative to PNL in lower pole stones larger than 2 cm, especially in selected patients.
authors.affiliation: Department of Urology, Yeditepe University Medical Faculty, Istanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Koyuncu
authors.affiliation: Department of Urology, Yeditepe University Medical Faculty, Istanbul, Turkey.
authors.forename: Faruk
authors.initials: F
authors.lastname: Yencilek
authors.affiliation: Department of Urology, Fatih University Medical Faculty, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kalkan
authors.affiliation: Department of Urology, Beykoz State Hospital, Istanbul, Turkey.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Bastug
authors.affiliation: Department of Radiology, Haydarpasa Training and Research Hospital, Istanbul, Turkey.
authors.forename: Esin
authors.initials: E
authors.lastname: Yencilek
authors.affiliation: Department of Urology, Yeditepe University Medical Faculty, Istanbul, Turkey.
authors.forename: Ahmet Tunc
authors.initials: AT
authors.lastname: Ozdemir
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007668:Kidney / Q000601:surgery; D007669:Kidney Calculi / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018666:Ureteroscopy / Q000379:methods*; D055815:Young Adult