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Objective: We aimed to determine the safety and efficacy of flexible ureterorenoscopy and Holmium laser lithotripsy in treating multiple intrarenal stones. Materials and Methods: We identified 32 consecutive patients with multiple intrarenal stones who underwent flexible ureterorenoscopy and/or laser lithotripsy performed by a single surgeon. Informed consent was obtained from all participants before treatment. Each patient was evaluated in terms of stone location, stone number, stone size, stone burden (cumulative stone length), body mass index, operative time, stone-free rate, and perioperative complications. Results: The median age of the patients was 38 years [interquartile range (IQR), 34.25-52.00]. The patients had a total of 75 intrarenal calculi. The average number of stones per patient was 2.50 (IQR, 2.0-3.0). The median total stone burden per patient was 23.0 mm (IQR, 19.0-28.0 mm). Twenty-one patients (65.5%) had stone burdens >20 mm, and 11 (34.5%) had burdens ≤20 mm. The overall final stone-free rate was 78.1%. The stone-free rates for patients with stone burdens ≤20 mm and >20 mm were 81.8% (9/11) and 76.2% (16/21), respectively (p=0.544). A perioperative complication (urinary leakage) occurred in one patient. Postoperative complications were recorded in four (12.5%) patients; a urinary tract infection in one, pain requiring parenteral medication in two, and hematuria in one. Conclusion: Flexible ureterorenoscopy combined with laser lithotripsy may be an effective treatment option for patients with multiple intrarenal stones; we noted only a few minor complications. The success rate was higher in patients with stone burdens ≤20 mm. |
