Urology Annals

LETTER TO EDITOR
Year
: 2020  |  Volume : 12  |  Issue : 1  |  Page : 106-

RE: Miniaturized percutaneous nephrolithotomy versus retrograde intrarenal surgery in the treatment of renal stones with a diameter <15 mm: A 3-year open-label prospective study


Mohd Nazli Kamarulzaman 
 Department of Surgery, Urology Unit, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia

Correspondence Address:
Dr. Mohd Nazli Kamarulzaman
Department of Surgery, Kulliyyah of Medicine, International Islamic University Malaysia, Jalan Penjara, Kuantan 25100, Pahang
Malaysia




How to cite this article:
Kamarulzaman MN. RE: Miniaturized percutaneous nephrolithotomy versus retrograde intrarenal surgery in the treatment of renal stones with a diameter <15 mm: A 3-year open-label prospective study.Urol Ann 2020;12:106-106


How to cite this URL:
Kamarulzaman MN. RE: Miniaturized percutaneous nephrolithotomy versus retrograde intrarenal surgery in the treatment of renal stones with a diameter <15 mm: A 3-year open-label prospective study. Urol Ann [serial online] 2020 [cited 2020 May 25 ];12:106-106
Available from: http://www.urologyannals.com/text.asp?2020/12/1/106/270532


Full Text



Sir,

I read with great interest the article “Miniaturized percutaneous nephrolithotomy versus retrograde intrarenal surgery (RIRS) in the treatment of renal stones with a diameter <15 mm: A 3-year open-label prospective study” by Mhaske et al.[1] This article highlights important findings regarding the safety and efficacy of both mini-percutaneous nephrolithotomy (mini-perc) and RIRS. In most of the previous similar comparative study, renal stone size <2cm was used as a cutoff point. It is an eye-opening to reduce the size to <1.5cm and to compare the efficacy of both procedures. However, the other study by Suresh et al. taken a more specific size as cutoff point which was between 1 cm and 1.5 cm.[2] This will better prospective as moss of stone <1 cm can be treated with extracorporeal shock wave lithotripsy. As stated by the author, the objective of this study was to compare between mini-perc and RIRS regarding stone-free rate, retreatment rate, complications, hospital stay, operative time, and reduction in hemoglobin level. The result shows that there was statistically significant difference in term of operative time but not different in-hospital stay. In the same times, the authors describe RIRS as 3-stage procedure namely: pre-RIRS stenting, RIRS procedure, and removal of stent. On the other hand, the operative time only calculates based on RIRS procedure alone. It was also applied in the calculation of hospital stay. As described by author the pre-RIRS was done under general anesthesia which need at least patient being admitted as daycare. In which will add extra more hospital stay and operative time. This matter was previously highlighted by Sabnis et al. in their paper.[3] In short, both procedures had their on advantages and disadvantages limited by their specific step of each procedure. In my opinion, RIRS has at least three compulsory specific steps of procedure as highlighted earlier. Each step required at least day care admission which will lead to absence from work. Thus, the conclusion of less hospital stay in RIRS is misleading the reader.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Mhaske S, Singh M, Mulay A, Kankalia S, Satav V, Sabale V. Miniaturized percutaneous nephrolithotomy versus retrograde intrarenal surgery in the treatment of renal stones with a diameter &lt;15 mm: A 3-year open-label prospective study. Urol Ann 2018;10:165-9.
2Suresh D, Chengalvarayan G, Muthulatha N, Illamparuthi C. Safety and efficacy of mini-PCNL as compared to RIRS in lower pole calculus 1-1.5cm. Int J Curr Adv Res 2017;6:1802-4.
3Sabnis RB, Ganesamoni R, Doshi A, Ganpule AP, Jagtap J, Desai MR. Micropercutaneous nephrolithotomy (microperc) vs. retrograde intrarenal surgery for the management of small renal calculi: A randomized controlled trial. BJU Int 2013;112:355-61.