Comparison of retrograde intrarenal surgery and percutaneous nephrolithotomy results for 20-30 mm kidney stones: A matched-pair analysis

Objective: To compare the results of retrograde intrarenal surgery and percutaneous nephrolithotomy for 20-30 mm kidney stones.Material and Methods: The demographic, radiologic, clinic and surgery related data of 324 patients who underwent retrograde intrarenal surgery and percutaneous nephrolithotomy for 20-30 mm kidney stones between January 2013 and July 2022 were retrospectively analyzed. All patients were divided into two roups as retrograde intrarenal surgery group and percutaneous nephrolithotomy group according to the surgery performed. After matching two groups in terms of age, number of stones, location of stones, stone size and stone density, 122 patients were included in the study (61 patients in retrograde intrarenal group and 61 patients in percutaneous nephrolithotomy group as 1:1).Results: The success rate of retrograde intrarenal surgery group (78.7%) and percutaneous nephrolithotomy group (80.2%) were similar (p=0.823). There was no difference between two groups in terms of infective and non-infective complications (respectively, p=0.752 and p=0.61). There were statistically significant difference between the two groups in duration of operation and hospitalization. The median operation time was 70 (30-100) minutes and the median hospital stay was 1 (1-28) days in the RIRS group, while the median operation time was 90 (50-160) minutes and the median hospital stay was 4 (2-10) days in the PNL group (p<0.001).Conclusion: Retrograde intrarenal surgery is a good alternative in the surgical treatment of 20-30 mm kidney stones with similar success and complication rates and also shorter operation time and hospitalization time.