Urology Research & Practice

The Prime Time for Flexible Ureteroscopy for Large Renal Stones Is Coming: Is Percutaneous Nephrolithotomy No Longer Needed?


Department of Urology, Istanbul University Istanbul School of Medicine, Istanbul, Turkey


European Association of Urology, Young Academic Urologist, Urolithiasis and Endourology Working Group, Arnhem, Netherlands


Department of Urology, University of Health Sciences, Ankara Sanatorium Training and Research hospital, Ankara, Turkey


Department of Urology, Campus Bio-Medico, University of Rome, Rome, Italy


Department of Urology, Father Muller Medical College, Mangalore, India


Department of Urology/Urooncology, University College of London Hospitals (UCLH), London, United Kingdom


Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom

Urol Res Pract 2023; 49: 280-284
DOI: 10.5152/tud.2023.23142
Read: 1200 Downloads: 427 Published: 29 September 2023

Advances in laser technology and surgical telescopic systems have propelled retrograde intrarenal surgery (RIRS) to the forefront as a viable alternative to percutaneous nephrolithotomy (PCNL). Currently, RIRS is being increasingly utilized as a treatment option, even for kidney stones larger than 2 cm. In this narrative review, we aimed to take a snapshot of current practice in renal stone treatment and the latest technological and technical developments and to evaluate the efficacy of RIRS in larger renal stones. With low complication rates and acceptable stone-free rates, RIRS offers patients a less invasive option with favorable outcomes. There are insufficient data comparing PCNL with RIRS using a new-generation high-power laser and suctioning ureteral access sheath (UAS). Further studies with novel lasers and UAS could provide superiority in terms of RIRS. It is crucial to take into account various patient-specific considerations, such as stone location and burden, when deciding on the appropriate treatment approach.

Cite this article as: Tonyali S, Haberal HB, Esperto F, et al. The prime time for flexible ureteroscopy for large renal stones is coming: is percutaneous nephrolithotomy no longer needed?. Urol Res Pract. 2023;49(5):280-284.

EISSN 2980-1478