Retrograde intrarenal surgery or percutaneous nephrolithotomy in the treatment of impacted proximal ureteric calculi

Abstract The objective of this study was to compare the clinical efficacy of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) in the treatment of impacted proximal ureteric calculi. This was a retrospective study on surgical outcomes of 202 patients with impacted proximal ureteric calculi. Overall, 140 and 62 were treated with RIRS and PCNL, respectively. The effects of the choice of the surgical method on the surgical outcomes were evaluated by preoperatively scoring patients with high-risk factors related to stone characteristics and analyzing these scores. Compared to the RIRS group, the surgical duration of the PCNL group was significantly shorter (51.69 ± 25.07 min vs. 67.46 ± 27.12 min, p < 0.05), stone-free rate (SFR) was significantly increased (98.4% vs. 72.10%, p < 0.05), and total treatment cost was lower (US $1678.61 ± 714.86 vs. US $3901.45 ± 1069.46, p < 0.05). Preoperatively, the efficacy of PCNL was higher than that of RIRS based on the higher scores observed. The results indicated PCNL had a better SFR and higher surgical efficacy, whereas RIRS had higher surgical safety parameters, a shorter perioperative period, but a lower initial SFR. PCNL is often more advantageous for complicated impacted proximal ureter stone.