Search

Urolithiasis is one of the most common urological conditions (30–45 %), peaking in the 4th–6th decades of life. About 50 % of patients have one recurrent episode of nephrolithiasis during their lifetime, and among the operated patients, more than 10–15 % of individuals report recurrences with the need for repeated surgical treatment. Increasing the incidence of nephrolithiasis in the world requires the development of new and improvement of existing methods of surgical treatment, which would be characterized by a high level of efficiency and low invasiveness with minimal complications and postoperative rehabilitation. The use of a combination of percutaneous nephrolithotripsy and flexible ureteronephrolithotripsy, especially in complex cases of urolithiasis, can increase the safety and improve the treatment of nephrolithiasis by combining the positive qualities of both methods. Aim. To summarize the data of the world scientific literature on the treatment of nephrolithiasis by studying a combination of percutaneous nephrolithotripsy and retrograde or antegrade flexible intrarenal surgery based on the evaluation of their effectiveness and safety. Materials and methods. The literature review was conducted using the databases PubMed, Google Scholar, Web of Science and Scopus for the period 2015–2022. The following keywords were used for the search: surgical treatment of nephrolithiasis, endoscopic combined intrarenal surgery (ECIRS), percutaneous nephrolithotomy, retrograde intrarenal surgery, simultaneous use of flexible ureterorenoscopy and percutaneous nephrolithotomy, simultaneous use of flexible ureterorenoscopy and percutaneous nephrolithotripsy. Conclusions. The use of ECIRS increases the effectiveness of one-stage treatment of nephrolithiasis with minimal complications and reduces the number of re-operations required. Treatment of complex forms of nephrolithiasis may be a priority for ECIRS. The main disadvantages of ECIRS are the need for simultaneous operation of two operating surgeons and the availability of two sets of endoscopic equipment, which make this procedure expensive.

Abstract Introduction and aim of the study: Urolithiasis is a disease involving the formation of deposits in the lumen of the urinary tract. The continued development of minimally invasive treatment methods allows for more effective treatment with greater operator comfort and less risk to the patient. It has been concluded that retrograde intrarenal surgery (RIRS) is superior to other therapeutic methods in many respects. The aim of this study is to review the available studies and publications and to identify potential complications following treatment of kidney and ureteral stones by RIRS, with a particular focus on infectious complications and their risk factors. Method and materials: We reviewed the literature available on PubMed and Google Scholar, using the words 'urolithiasis'; 'urolithiasis treatment'; 'retrograde intrarenal surgery'; 'infectious complications of retrograde intrarenal surgery'. Results: Among the risk factors associated with infectious complications after RIRS, long duration of surgery, recent positive urine culture, urinary tract infections or antibiotic use, purulent urine, urinary nitrites, obstructed access through the ureter, struvite stones, co-morbidities play a special role. Conclusions: Among the complications of surgical treatment of nephrolithiasis and ureteral stones by RIRS, infectious complications are of particular concern. In view of the knowledge of their risk factors, preventive measures should include limiting the duration of surgery, possible antibiotic therapy and considering the use of a larger diameter UAS. This is especially true for patients with abnormal urine results, struvite stones, a history of urinary tract infection or predisposing comorbidities. Key words: Urolithiasis; Kidney Calculi; Retrograde Intrarenal Surgery; Urolithiasis infection;