Sarioglu Caglar, Senel Samet, Uzun Emre, Polat Muhammed Emin, Ceviz Kazim, Odabas Oner, Koudonas Antonios
Department of Urology, Ankara City Hospital, Ankara, Turkey.
First Department of Urology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Cent European J Urol. 2023;76(4):325-330. doi: 10.5173/ceju.2023.189. Epub 2023 Nov 13.
Inversion of the patient, forced diuresis after hydration, and mechanical percussion technique was developed for lower renal pole (LRP) stones with extracorporeal shock wave (ESWL). In this study, we aimed to analyze the effect of percussion, diuresis and inversion (PDI) therapy on the success rates of retrograde intrarenal surgery (RIRS) for the LRP stones.
114 patients who underwent RIRS for LRP stones <2cm were included in this study. Patients' demographic, clinical, radiological and anatomical features and success status were recorded prospectively. The patients were divided into two groups. One group received RIRS procedure only (non-PDI group) and the other group received PDI therapy after the RIRS procedure (PDI group).
PDI was performed to 60 (52.6%) patients, and not performed to 54 (47.4%) patients. The success rate (58.3%) for the PDI group was higher than the non-PDI group (25.9%), and this difference was statistically significant (p <0.001). In multivariate logistic regression analysis, stone size (OR = 1.306; 95% CI = 1.019-1.674; p <0.001), IU (OR = 1.702; 95% CI = 1.383-2.096; p <0.001) and not performing PDI therapy (p <0.001) OR = 9.455; 95% Cl = 2.426-10.853; p = 0.001) were revealed to be independent risk factors for failure.
PDI therapy increases the success rates of RIRS performed for the LRP stones.
为了治疗体外冲击波碎石术（ESWL）治疗下肾盏（LRP）结石，开发了患者倒置、水化后强制利尿以及机械叩击技术。在本研究中，我们旨在分析叩击、利尿和倒置（PDI）疗法对LRP结石逆行肾内手术（RIRS）成功率的影响。
本研究纳入了114例接受RIRS治疗<2cm的LRP结石患者。前瞻性记录患者的人口统计学、临床、放射学和解剖学特征以及手术成功情况。患者分为两组。一组仅接受RIRS手术（非PDI组），另一组在RIRS手术后接受PDI治疗（PDI组）。
60例（52.6%）患者接受了PDI治疗，54例（47.4%）患者未接受PDI治疗。PDI组的成功率（58.3%）高于非PDI组（25.9%）），且差异具有统计学意义（p<0.001）。在多因素逻辑回归分析中，结石大小（OR=1.306；95%CI=1.019-1.674；p<0.001）、肾盂积水（OR=1.702；95%CI=1.383-2.096；p<0.001）以及未进行PDI治疗（OR=9.455；95%CI=2.426-10.853；p=0.001）被发现是手术失败的独立危险因素。
PDI疗法提高了LRP结石RIRS手术的成功率。
