DOI: 10.36347/sjams.2021.v09i03.037

Pages: 493-499

Introduction and Objective: Urolithiasis is one of the most common urological disorder today. Though PCNL is the gold standard treatment for large renal stones, Semirigid or flexible RIRS is evolving as a treatment modality for fair sized renal calculi up to 2-2.5 cm. The objectives of this study are to assess usefulness, effectiveness and complications of RIRS using semi rigid ureterorenoscope in treatment of urolithiasis. Methods: This is hospital based prospective, observational study of 30 patients of renal calculi sized >1.5cm and <3cm. They were willing to undergo RIRS with semirigid ureterorenoscope at the beginning. Later if required, they underwent PCNL. ESWL was given later after 3 weeks, if required. Extent of stone clearance and complications were recorded. All patients were followed up at 3 weeks and 3 months to check for residual stones. Results: The major advantages of semirigid ureterorenoscopes are stone free rate of 33.33% without any additional ESWL, good vision, better accessibility, long instrument stability and low incidence of complications (mild UTI 3.33%). Follow up along with ESWL, additional stone clearance rate was 30%. So the total stone clearance rate of sRIRS with or without ESWL was 63.33%. Remaining 11(36.67%) were converted to PCNL due to poor or non visibility of stone. In these patients, 8 cases (26.67%) achieved complete stone clearance and in 3 cases (10%) additional ESWL was required. Conclusion: RIRS with semirigid ureterorenoscope is effective, safe and alternate treatment modality to PCNL. sRIRS is completely successful in one third of patients and combined with ESWL, complete stone clearance is achieved in two third of the patients. Surprisingly, the grade of hydronephrosis, internal architectures of PC system and angulation at PUJ has no correlation with the outcome.