[Causes and remediations of retrograde intrarenal surgery failure in renal calculi treatment].

ABSTRACT

OBJECTIVE: To find the causes of retrograde intrarenal surgery (RIRS) failure in renal calculi treatment and evaluate the efficacy and morbidity of remedial measures. METHODS: All the patients with renal stone who had undergone RIRS in the last two years were reviewed and the failure cases screened out according to operating records. RESULTS: Within the 132 patients, 19 RIRS procedures failed. The causes of failure included ureteral (42.1%), intrarenal (36.8%), stone (10.5%) and operating reason (5.3%).The caculi of 11 patients were cleaned by remedial percutaneous nephrolithotomy (PCNL), seven patients had secondary RIRS one week later, and only one patient left the renal stone for observation and dietary regulation. Sixteen patients were stone-free after remedial treatment and the complications included ureteral perforation in one case and high fever in 4 cases. CONCLUSION: The main causes of RIRS failure are ureteral incompatibility and intrarenal disadvantageous anatomy. PCNL and secondary RIRS are the effective remedial measure after RIRS failure.