Few studies compared PCNL and RIRS for stones in solitary kidney. Current guidelines do not provide clear recommendations concerning the management of renal stones in patients with solitary kidney. The study aims to compare the safety and efficacy of the use of percutaneous nephrolithotomy (PCNL) and flexible ureteroscopy in the treatment of renal stones \_ ≤ 3 cm in largest diameter through a prospective non randomized study in the period between August 2024 and August 2026. Stone-free rate will be assessed by NCCT done at 1st day postoperative and after 3 months. For Evaluation of kidney function postoperatively, creatinine clearance will be done after 1month and renal isotope scan will be done after 3 months. In addition, the results will be compared to the data of the patients with solitary kidney and renal stones who were retrospectively treated by PCNL or RIRS in the period between 2002 and 2024. The cases should fulfil the same inclusion criteria of the prospective study.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
83
standard retrograde intrarenal surgery (RIRS) for management of stones in solitary kidney
standard percutaneous nephrolithotomy (PCNL) for management of stones in solitary kidney
Urology and Nephrology center , Mansoura University
Al Mansurah, Dakahlia Governorate, Egypt
stone free rate
Stone-free status: it will be assessed by NCCT (defined as the absence of any stones or presence of only clinically insignificant residual stones \< 4 mm as measured by NCCT). Sub classified to * Initial stone free rate (1st day postoperative) * Final stone free rate (after 3 months)
Time frame: within 3 months after surgery
complication rate
intra-operative and post operative complications according to clavien- dindo classification
Time frame: within 30 days after surgery
number of sessions
number of sessions needed to achieve complete stone clearance
Time frame: 3 months after surgery
renal function evaluation
renal function assessed by eGFR
Time frame: within 3 months after surgery
auxiliary procedures
need for auxiliary procedures after primary intervention
Time frame: within 3 months after surgery
hospital stay
duration of postoperative hospital stay
Time frame: from date of surgery until hospital discharge ( up to 30 days )
renal function evaluation
assessment of renal function by serum creatinine
Time frame: within 1 month after surgery
renal function evaluation
assessment of renal function by DTPA renography
Time frame: within 3 months after surgery
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