comparison between percutaneous nephrolithotomy and retrograde flexible nephrolithotripsy in obese patients with 2 - 4 cm renal stones

Background: nowadays, because of remarkable advancements in retrograde intrarenal surgery (rirs), modest attention toward this procedure as the second or alternative choice for renal stones treatment has been drawn. objectives: in the present study, we compared rirs and percutaneous nephrolithotomy (pcnl) outcomes in treating obese patients with 2 - 4 cm renal stones. methods: eighty-two patients who underwent pcnl (n = 40) and rirs (n = 42) between june 2015 and december 2018 at the department of urology of sina hospital were enrolled in our retrospective cohort study. results: after the first surgery session, stone-free rates for the rirs group were 92.9% and for the pcnl group was 95% (p value = 0.52). the mean operation time for the rirs and pcnl groups were 71.6 ± 11 and 93.3 ± 12.2, respectively (p < 0.001). the hospitalization stay for all of the pcnl group was more than 1 day (mean = 2.5 days); however, that for the majority of the rirs group was less than 1 day (p < 0.001). the analgesic use in the rirs group was significantly lower than in the pcnl group (9.0 ± 5.5, 61.8 ± 13.6, respectively; p < 0.001). the overall complication rates were higher in the rirs group. however, none of them were statically significant (p > 0.05). conclusions: according to satisfactory outcomes obtained in the rirs groups, it can be concluded that rirs can be applied as an alternative or even the first choice in obese patients with 2 - 4 cm renal stones.