Comparison of Mini Percutaneous Nephrolithotomy (Mini PCNL) and Retrograde Intrarenal Surgery (RIRS) for the Minimal Invasive Management of Lower Caliceal Stones

Purpose: To evaluate the stone-free rates, quality of life, complications, use of fluoroscopy, analgesic requirements, and hospital stay following the management of lower calyceal with two different techniques (Mini Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery) in a prospective manner. Material and Methods: 50 patients diagnosed with lower pole 1-2 cm stone were included in the study and randomized into two groups. (Mini PCNL n: 25) ( RIRS n: 25). The safety and efficacy of both methods, along with some other certain related factors, were comparatively evaluated in both groups. Results: There was no significant difference between preoperative stone size, stone-to-skin distance, hemogram, creatinine values, need for the analgesic drug, patients replies to visual analog scale (VAS). The duration of both the hospital stay and the exposure to fluoroscopy, hematocrit decrease due to hemorrhage; complication rates were significantly higher in cases undergoing mini PCNL when compared to RIRS. Additionally, no significant difference was observed concerning the stone-free rates. Despite an increase in quality of life following both types of operations, there was no significant difference in the quality of life between the patients in both groups. Conclusion: Our findings demonstrated that both surgical techniques are feasible alternatives in the minimally invasive treatment of lower pole stones. Although there was no meaningful difference in stone-free rates between the two groups, complications, use of fluoroscopy, bleeding, and duration of hospital stay were noted to be significantly higher in cases treated with mini PCNL.