Comparison of percutaneous nephrolithotomy and retrograde fl exible nephrolithotripsy for the treatment of 2 – 4 cm stones

Stone disease which is also called as urolithiasis is as old as the history of the humankind. It is the third common complaint detected in the urology practice after urinary tract infectıon and prostate disease. Several methods are used in the treatment of stone diseases. Medical treatment, extracorporeal shock wave lithotripsy (ESWL), retrograde intrarenal surgery (RIRS), percutaneous nephrolithopaxie (PNL), laparoscopy, combination therapy and open surgery are the treatment options. A total of 143 patients consisting of 86 patients (53 Male/ 33 Female) who undergone PNL surgery and 57 patients (37 Male/ 20 Female) who undergone RIRS between October 2009 and October 2013 at the Urology Department of Fırat University Hospital were included to the study. Detailed history taking and physical examination according to systemic diseases was provided. The patients were evaluated with CBC, creatinine, coagulation parameters and urine culture. The patients with positive urine culture received antibiotic therapy accordingly before undergoing operation. Recently a successful stone disease treatment could be achieved with RIRS and PNL but PNL is still the golden standart option for kidney stones greater than 2 cm. But also a successful treatment by kidney stones of diameter from 2 to 4 cm. could be realised by performing repeated RIRS sessions This study revealed that RIRS could be an alternative to PNL by kidney stones of diameter between 2 to 4 cm. due to it's low rate of complications, short hospitalisation period and the high success rate by repeated sessions especially by patients with comorbidities. This results need to be confirmed with more prospective studies. Key words: Percutaneous Nephrolithopaxie, Retrograde Intrarenal Surgery, Kidney Stones, Flexible Uretheroscopy.