Category: Clinical Stones: Ureteroscopy

MP29-20 - Does Previous Open or Percutaneous Renal Stone Surgery Affect on Retrograde Intrarenal Surgery Outcomes?

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective : Open or percutaneous renal stone surgeries can have an adverse effect on kidney collecting system. In the current study, we evaluated the effect of open or percutaneous renal stone surgery on retrograde intrarenal surgery (RIRS) outcomes in patients with ≤3 cm renal stones.


Methods : A total of 758 patients with ≤3 cm renal stones underwent RIRS treatment at our clinic between September 2013 and January 2018 were included in this study. Sixty of these had previous open or percutaneous renal stone surgery history (group 1). The remaining patients had no history of renal stone surgery (group 2, n=698). At postoperatively first month, ≤3 mm residual stones were accepted as stone free. The groups were compared in terms of age, stone size, stone-free rates and complications.


Results : The mean age of the patients was 51.1±14.7 (12-86) and 45.7±14.7 (16-84) years in group 1 and 2, respectively (p=0.04). The mean stone size was 17.0±7.4 (7-30) and 15.0±6.1 (5-30) mm in group 1 and 2, respectively (p=0.06). Operative results were summarized in Table 1. According to our results, total stone free ratewere significantly higher in Group 2. The OR was 2.01 ([95% CI, 1,10-3,63], p=0.02) for open or percutaneous renal stone surgery history. The mean duration of hospitalization was 1.1±1.2(0-8) and 1.4±1.8 (0-9) days in group 1 and 2, respectively (p=0.07). Also, according to postoperative Clavien 1-2 complications were higher in Group 1, but there was no difference between the two groups in terms of Clavien 3a complications. Clavien> 3a complication was not seen in any patients.


Conclusions : According to our results, previous open or percutaneous renal stone surgeryhas negativeeffect on success and complication rates in RIRS. Therefore, patients should be well informed before operation.

Altug Tuncel

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Dr. Altug Tuncel received a medical degree from the Gazi University, Ankara, Turkey in 1996 and completed his medical proficiency training at the same university in Urology Department on March 2002. Later he started to work as a chief assistant at the Third Urology Clinic at Ankara Numune Research and Training Hospital of Ministry of Health on July 2002. Then, he got the Scientific and Technological Research Council of Turkey (TUBITAK)’s Postdoctoral Research Scholarship and worked as a research fellow for 9 months at University of Texas (USA), Faculty of Medicine, Southwestern Medical Centre, Department of Urology, Minimally Invasive Surgical Division under the guidance of Prof.Dr.Jeffrey A.Cadeddu and took part in some research projects on endourology and urooncology. At Minimally Invasive Surgical Training Centre of the same Department, he was trained in urologic laparoscopic surgery through practical work at wet laboratory with animal models and at dry laboratory with Virtual Reality Simulator (Lap Mentor®). He also attented laparoscopic operations done by Prof.Dr.Cadeddu as observer. After turning back to Turkey, he has started doing urologic laparoscopic surgeries at the clinic where he is currently working. He got the title of associate professor on December 2008. He was promoted to post of Professor at the University of Health Sciences Faculty of Medicine, Department of Urology, Turkey. Dr.Tuncel who has certificate of Turkish Urology Proficiency Council and Certification of Fellows of the European Board of Urology (FEBU). In his urology practices focuses more on endourology and urooncology.

Ozer Guzel

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Ahmet Asfuroglu

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of urology
Ankara, Ankara, Turkey

Can Aykanat

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Melih Balci

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Yilmaz Aslan

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Seref Coser

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Ali Ozercan

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey