Retrograde Intrarenal Surgery for Asymptomatic Renal Stones: Outcomes and Stone-free Rates

What is it about?

The FLEXible Ureteroscopy Outcomes Registry (FLEXOR) study examined 679 patients with asymptomatic incidental renal stones (AIRS) who underwent retrograde intrarenal surgery (RIRS). The study found that RIRS had a favourable stone-free rate (SFR) with acceptable complications. The use of holmium laser and multiple stones were factors associated with lower odds of being stone-free. The study highlights the pros and cons of offering RIRS to patients with AIRS and demonstrates that pre-emptively discussing potential re-intervention helps patients make informed decisions, particularly in cases involving large and multiple stones.

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Why is it important?

The research examines the use of retrograde intrarenal surgery (RIRS) for patients with asymptomatic incidental renal stones (AIRS) and assesses surgical outcomes and stone-free rates. Among 679 patients with AIRS, 640 met the inclusion criteria. The median age was 55 years, with 33.4% being female. In all, 22.1% had positive urine cultures. The median stone diameter was 12 mm, commonly in lower and interpolar locations. RIRS was preferentially performed under general anaesthesia using a reusable scope in 443 cases. The overall complications were minimal, with sepsis in 1.6% of patients. The study demonstrates a favourable stone-free rate with acceptable complications. Key Takeaways: 1. The study highlights the pros and cons of offering RIRS to patients with AIRS. 2. The study shows a favourable stone-free rate with acceptable complications for RIRS in patients with AIRS. 3. Pre-emptively discussing potential re-intervention helps patients make informed decisions, particularly in cases involving large and multiple stones.