Introduction: Kidney stones occur more frequently in patients with a horseshoe kidney (HSK) anomaly. Abnormal anatomy may make the stone removal procedures more difficult. Therefore we aimed to evaluate and compare retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) for the treatment of renal stones in the HSK anomaly.
Material and methods: In this descriptive study, patients with HSK anomaly who underwent RIRS and PCNL procedures were retrospectively evaluated. Demographic and renal stone characteristics, success and complications associated with the surgical methods were compared across patients.
Results: A total of 49 patients were evaluated, 28 underwent RIRS and 21 underwent PCNL. No differences were determined between the groups concerning the demographics of patients and stone characteristics. A single session and final stone-free rate was 71.4% and 85.7% in RIRS, 81% and 90.5% in PCNL (both p ≥0.05). However, RIRS had more re-treatment rate, while its mean length of hospital stay was shorter than PCNL (p = 0.035, p = 0.001). While no differences were detected between the associated complication rates, more of the complications encountered in the PCNL group were of a serious nature.
Conclusions: In the HSK anomaly, renal stones can be treated with RIRS and PCNL procedures with high success. With its minimal morbidity, low complication rates and the minor character of the associated complications, the RIRS procedure can sometimes be preferred to avoid complications related to PCNL in HSK anomaly with big sized kidney stones.
Keywords: horseshoe kidney; morbidity; nephrolithotomy; percutaneous; renal stone; retrograde intrarenal surgery; success.
Conflict of interest statement
The authors declare no conflicts of interest.
Propensity Score-Matched Analysis Comparing Retrograde Intrarenal Surgery With Percutaneous Nephrolithotomy for Large Stones in Patients With a Solitary KidneyX Shi et al. J Endourol 32 (3), 198-204. PMID 29212373.With fewer repeated surgical procedures, higher EQ, and comparable total costs, PCNL is recommended as the first choice for the treatment of large renal calculi in patien …
Percutaneous Nephrolithotomy Versus Retrograde Intrarenal Surgery: A Systematic Review and Meta-AnalysisS De et al. Eur Urol 67 (1), 125-137. PMID 25064687. - ReviewPCNL is associated with higher stone-free rates at the expense of higher complication rates, blood loss, and admission times. Standard PCNL offers stone-free rates superi …
Comparison of Retrograde Intrarenal Surgery and Percutaneous Nephrolithotomy for the Treatment of Renal Stones Greater Than 2 CmO Karakoç et al. Turk J Urol 41 (2), 73-7. PMID 26328205.This study revealed that RIRS can be an alternative to PCNL in the treatment of kidney stones with a diameter of 2-4 cm especially in patients with comorbidities.
Extracorporeal Shock Wave Lithotripsy (ESWL) Versus Percutaneous Nephrolithotomy (PCNL) or Retrograde Intrarenal Surgery (RIRS) for Kidney StonesA Srisubat et al. Cochrane Database Syst Rev (11), CD007044. PMID 25418417. - ReviewResults from five small studies, with low methodological quality, indicated ESWL is less effective for kidney stones than PCNL but not significantly different from RIRS. …
Comparison of Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery in Treating 20-40 Mm Renal StonesG Atis et al. Urol J 14 (2), 2995-2999. PMID 28299761.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 4 …
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