Comparison of Mini-perc and Retrograde Intrarenal Surgery in Residual Stone Fragments with Hounsfield Unit after Percutaneous Nephrolithotomy

Introduction: Retrograde Intrarenal Surgery (RIRS) and Minimally invasive PCNL (also termed mini-PCNL or mini-Perc or mPCNL) mini-perch surgery are two methods of residual stone treatment. We aim to compare the results of mini-perch and RIRS to treat residual stones after PCNL with Hounsfield unit over 1000. In this retrospective cohort study patients with residual stones after PCNL with Hounsfield unit above 1000 or a stone-to-skin distance greater than 10 cm divided into two groups of mini perch or RIRS.Methods: Total number of 32 patients in the RIRS group (mean age 38.68±8.00) and 35 patients in the mini-perc group (mean age 42.05±13.22) were studied. The hemoglobin loss (p-value=0.01), need for blood transfusion (p-value=0.04), hospital stay (p-value=0.006) and surgery time (p-value=0.001) were significantly lower in RIRS group.Results: Although the percentage of success (p-value=0.17) and Stone Free Rate (SFR) (p-value=0.401) were higher in the mini-perc group, it was not significantly different from RIRS. Complications in the mini-perc group were significantly higher than in the RIRS group (p-value=0.05).Conclusions: The RIRS method has no significant difference in comparison with mini-perc. RIRS have lower operation time, shorter hospitalization, and less complication.