title: Comparison of Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery in Treating 20-40 mm Renal Stones.
abstract: OBJECTIVE
  To compare the outcomes of percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) in treating renal stones between 20 and 40 mm in diameter.
  
  
  METHODS
  146 patients, who were treated with RIRS and 146 patients, who were treated with PCNL for renal stones between 20 and 40 mm in diameter were compared retrospectively using a matched-pair analysis. The operative and post-operative outcomes of both groups were analyzed retrospectively.
  
  
  RESULTS
  The mean age, gender, body mass index and stone laterality were similar between the groups. The mean stone size was 28.39 &plusmn; 4.67 mm for the PCNL group and 25.08 &plusmn; 6.07 mm for the RIRS group (P =.21). The mean operative times were statistically longer in the RIRS group, whereas the fluoroscopy times, hospitalization times and post-operative visual analogue scores were statistically higher in the PCNL group. The stone- free rates (SFR) after a single procedure were 91.7% in the PCNL group and 74% in the RIRS group (P = .04). After auxiliary procedures, the overall SFRs reached 94.4% for the PCNL group and 92.3% for the RIRS group (P = .52). No major complications were observed for both groups. Minor complication (Clavien 1-3) rates were 6.8% and 3.4% for the PCNL and RIRS group, respectively (P =.18).
  
  
  CONCLUSIONS
  RIRS has some advantages over PCNL such as shorter hospitalization times, shorter fluoroscopy times and less post-operative pain in treating renal stones between 20 and 40 mm in diameter. However, PCNL has a higher SFR with only a single session.
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital, Urology, Istanbul, TR. gokhanatis@hotmail.com.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Atis
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital, Urology, Istanbul, TR.
authors.forename: Meftun
authors.initials: M
authors.lastname: Culpan
authors.affiliation: Harran Universitesi School of Medicine, Urology, Sanliurfa, TR.
authors.forename: Eyup Sabri
authors.initials: ES
authors.lastname: Pelit
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital, Urology, Istanbul, TR.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Canakci
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital, Urology, Istanbul, TR.
authors.forename: Ismail
authors.initials: I
authors.lastname: Ulus
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital, Urology, Istanbul, TR.
authors.forename: Bilal
authors.initials: B
authors.lastname: Gunaydin
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital, Urology, Istanbul, TR.
authors.forename: Asif
authors.initials: A
authors.lastname: Yildirim
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital, Urology, Istanbul, TR.
authors.forename: Turhan
authors.initials: T
authors.lastname: Caskurlu
mesh_terms: D000328:Adult; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007668:Kidney / Q000601:surgery*; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects; D061646:Operative Time; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome