urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2022-10-3-98-105urovest-585Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS ARTICLEРетроградная интраренальная хирургия при камнях почек более двух сантиметровRetrograde intrarenal surgery for kidney stones larger than two centimetreshttps://orcid.org/0000-0003-2767-7153ПоповС. В.PopovS. V.

Сергей Валерьевич Попов — доктор медицинских наук, профессор; главный врач, руководитель городского центра эндоскопической урологии и новых технологий; профессор кафедры урологии

194044, Россия, г. Санкт-Петербург, ул. Чугунная, д. 46

194044, Россия, г. Санкт-Петербург, ул. Академика Лебедева, д. 6, лит. Ж

Sergey V. Popov — M.D., Dr.Sc. (Med), Full Prof.; Chief Medical Officer; Prof., Dept. of Urology

46 Chugunnaya St., St. Petersburg, 194044, Russian Federation

37A Academician Lebedev, St. Petersburg, 194044, Russian Federation

doc.popov@gmail.comhttps://orcid.org/0000-0001-5566-9789ОрловИ. Н.OrlovI. N.

Игорь Николаевич Орлов — кандидат медицинских наук; заместитель главного врача по медицинской части; ассистент кафедры урологии

194044, Россия, г. Санкт-Петербург, ул. Чугунная, д. 46

191015, Россия, г. Санкт-Петербург, ул. Кирочная, д. 41

Igor N. Orlov — M.D., Cand.Sc.(Med); Deputy Chief Medical Officer for Medical; Assist., Dept. of Urology

46 Chugunnaya St., St. Petersburg, 194044, Russian Federation

41 Kirochnaya St., St. Petersburg, 191015, Russian Federation

doc.orlov@gmail.comhttps://orcid.org/0000-0001-6085-5594СытникД. А.SytnikD. A.

Дмитрий Анатольевич Сытник — врач-уролог отделения урологии №1 городского центра эндоскопической урологии и новых технологий

194044, Россия, г. Санкт-Петербург, ул. Чугунная, д. 46

Dmitry A. Sytnik — M.D., Urologist, Urology Division No.1, City Centre of Endoscopic Urology and New Technologies

46 Chugunnaya St., St. Petersburg, 194044, Russian Federation

doc.dmitriysytnik@gmail.comhttps://orcid.org/0000-0002-9933-6270РаджабовР. М.RadzhabovR. M.

Расул Мурадисович Раджабов — клинический ординатор отделения урологии №1 городского центра эндоскопической урологии и новых технологий

194044, Россия, г. Санкт-Петербург, ул. Чугунная, д. 46

Rasul M. Radzhabov — Resident, Urology Division No.1, City Centre of Endoscopic Urology and New Technologies

46 Chugunnaya St., St. Petersburg, 194044, Russian Federation

radzhabov812@gmail.comСПб ГБУЗ «Клиническая больница Святителя Луки»; ФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Минобороны РоссииРоссияSt. Luke St. Petersburg Clinical Hospital; Kirov Military Medical AcademyRussian FederationСПб ГБУЗ «Клиническая больница Святителя Луки»; ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава РоссииРоссияSt. Luke St. Petersburg Clinical Hospital; Mechnikov North-Western State Medical UniversityRussian FederationСПб ГБУЗ «Клиническая больница Святителя Луки»РоссияSt. Luke St. Petersburg Clinical HospitalRussian Federation20220110202210398105Copyright © Попов С.В., Орлов И.Н., Сытник Д.А., Раджабов Р.М., 20222022Попов С.В., Орлов И.Н., Сытник Д.А., Раджабов Р.М.Popov S.V., Orlov I.N., Sytnik D.A., Radzhabov R.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.urovest.ru/jour/article/view/585

Согласно клиническим рекомендациям, перкутанная нефролитотрипсия является основным методом лечения пациентов с конкрементами почек более 2 см. Однако в последнее время опубликовано множество исследований, описывающих безопасность и эффективность ретроградной интраренальной хирургии (РИРХ) при лечении пациентов с конкрементами почек аналогичных размеров. Данная работа представляет собой обзор литературы, посвящённый применению РИРХ в лечении пациентов с конкрементами почек более 2 см. Целью исследования явилась оценка безопасности и эффективности РИРХ при лечении конкрементов почек более 2 см. Оценены такие показатели, как время оперативного лечения, показатель «stone-free rate», интра- и послеоперационные осложнения. Кратко затронут исторический аспект развития и становления уретероскопии как метода диагностики и лечения заболеваний верхних мочевых путей. Поиск материала проводили в следующих базах данных: PubMed, Scopus, Web of Science, Google Scholar.

According to the guidelines, percutaneous nephrolithotomy is the main treatment for patients with kidney stones larger than 2 cm. However, many studies have recently been published describing the safety and efficacy of retrograde intrarenal surgery (RIRS) in the treatment of patients with kidney stones of similar size. This paper reviews the literature on the use of RIRS in the treatment of patients with kidney stones larger than 2 cm. The study aims to evaluate the safety and efficacy of RIRS in the treatment of kidney stones larger than 2 cm. Such indicators as the duration of surgical treatment, stone-free rate, intra- and postoperative complications were evaluated. Also, the history of the development of ureteroscopy as a diagnostic and therapeutic method for diseases of the upper urinary tract is briefly reviewed. The material was searched in the PubMed, Scopus, Web of Science, and Google Scholar databases.

уретроскопияретроградная внутрипочечная хирургияуретероскопыодноразовые гибкие уретероскопыкамни в почкахкрупные камни в почкахкамни нижних чашечек почекпослеоперационные осложненияверхние мочевые путиисторияureteroscopyretrograde intrarenal surgeryureteroscopessingle-use flexible ureteroscopeskidney stoneslarge kidney stoneslower calyx kidney stonespostoperative complicationsupper urinary tracthistoryReferencesAssimos D, Krambeck A, Miller NL, Monga M, Murad MH, Nelson CP, Pace KT, Pais VM Jr, Pearle MS, Preminger GM, Razvi H, Shah O, Matlaga BR. Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART I. J Urol. 2016;196(4):1153-60. s://doi.org/10.1016/j.juro.2016.05.090Assimos D, Krambeck A, Miller NL, Monga M, Murad MH, Nelson CP, Pace KT, Pais VM Jr, Pearle MS, Preminger GM, Razvi H, Shah O, Matlaga BR. Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART I. J Urol. 2016;196(4):1153-60. s://doi.org/10.1016/j.juro.2016.05.090EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam, 2022. The Netherlands: Arnhem, 2022. URL: https://uroweb.org/guidelines/urolithiasisEAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam, 2022. The Netherlands: Arnhem, 2022. URL: https://uroweb.org/guidelines/urolithiasisAghamir SMK. Successful retrograde intrarenal surgery (RIRS) for a 2-centimeter stone in a chronic renal failure (CRF) patient. Int J Surg Case Rep. 2021;87:106375. s://doi.org/10.1016/j.ijscr.2021.106375Aghamir SMK. Successful retrograde intrarenal surgery (RIRS) for a 2-centimeter stone in a chronic renal failure (CRF) patient. Int J Surg Case Rep. 2021;87:106375. s://doi.org/10.1016/j.ijscr.2021.106375Pillai SB, Chawla A, de la Rosette J, Laguna P, Guddeti R, Reddy SJ, Sabnis R, Ganpule A, Desai M, Parikh A. Super-mini percutaneous nephrolithotomy (SMP) vs retrograde intrarenal surgery (RIRS) in the management of renal calculi ≤ 2 cm: a propensity matched study. World J Urol. 2022;40(2):553-562. s://doi.org/10.1007/s00345-021-03860-wPillai SB, Chawla A, de la Rosette J, Laguna P, Guddeti R, Reddy SJ, Sabnis R, Ganpule A, Desai M, Parikh A. Super-mini percutaneous nephrolithotomy (SMP) vs retrograde intrarenal surgery (RIRS) in the management of renal calculi ≤ 2 cm: a propensity matched study. World J Urol. 2022;40(2):553-562. s://doi.org/10.1007/s00345-021-03860-wLiu X, Xia D, Peng E, Tong Y, Liu H, Wang X, He Y, Chen Z, Tang K. Comparison of two techniques for the management of 2-3 cm lower pole renal calculi in obese patients. World J Urol. 2022;40(2):513-518. s://doi.org/10.1007/s00345-021-03872-6Liu X, Xia D, Peng E, Tong Y, Liu H, Wang X, He Y, Chen Z, Tang K. Comparison of two techniques for the management of 2-3 cm lower pole renal calculi in obese patients. World J Urol. 2022;40(2):513-518. s://doi.org/10.1007/s00345-021-03872-6Yıldızhan M, Balcı M, Asil E, Kızılkan Y, Aslan Y, Özden C, Tuncel A. Comparison of percutaneous nephrolithotomy and retrograde intrarenal surgery outcomes for kidney stones larger than 2 cm from Guy's stone scoring system perspective. Int J Clin Pract. 2021;75(12):e14956. s://doi.org/10.1111/ijcp.14956Yıldızhan M, Balcı M, Asil E, Kızılkan Y, Aslan Y, Özden C, Tuncel A. Comparison of percutaneous nephrolithotomy and retrograde intrarenal surgery outcomes for kidney stones larger than 2 cm from Guy's stone scoring system perspective. Int J Clin Pract. 2021;75(12):e14956. s://doi.org/10.1111/ijcp.14956Fayad MK, Fahmy O, Abulazayem KM, Salama NM. Retrograde intrarenal surgery versus percutaneous nephrolithotomy for treatment of renal pelvic stone more than 2 centimeters: a prospective randomized controlled trial. Urolithiasis. 2022;50(1):113-117. s://doi.org/10.1007/s00240-021-01289-9Fayad MK, Fahmy O, Abulazayem KM, Salama NM. Retrograde intrarenal surgery versus percutaneous nephrolithotomy for treatment of renal pelvic stone more than 2 centimeters: a prospective randomized controlled trial. Urolithiasis. 2022;50(1):113-117. s://doi.org/10.1007/s00240-021-01289-9Georgescu D, eds. Retrograde Ureteroscopy. Handbook of Endourology. Academic Press; 2016. eBook ISBN: 9780128026625.Georgescu D, eds. Retrograde Ureteroscopy. Handbook of Endourology. Academic Press; 2016. eBook ISBN: 9780128026625.Lyon ES, Kyker JS, Schoenberg HW. Transurethral ureteroscopy in women: a ready addition to the urological armamentarium. J Urol. 1978;119(1):35-6. s://doi.org/10.1016/s0022-5347(17)57372-3Lyon ES, Kyker JS, Schoenberg HW. Transurethral ureteroscopy in women: a ready addition to the urological armamentarium. J Urol. 1978;119(1):35-6. s://doi.org/10.1016/s0022-5347(17)57372-3Pérez-Castro Ellendt E, Martínez-Piñeiro JA. La ureterorrenoscopia transuretral. Un actual proceder urológico [Transurethral ureteroscopy. A current urological procedure]. Arch Esp Urol. 1980;33(5):445-60. (In Spanish) PMID: 7447504Pérez-Castro Ellendt E, Martínez-Piñeiro JA. La ureterorrenoscopia transuretral. Un actual proceder urológico [Transurethral ureteroscopy. A current urological procedure]. Arch Esp Urol. 1980;33(5):445-60. (In Spanish) PMID: 7447504Marshall VF. Fiber optics in urology. J Urol. 1964;91:110-4. s://doi.org/10.1016/s0022-5347(17)64066-7Marshall VF. Fiber optics in urology. J Urol. 1964;91:110-4. s://doi.org/10.1016/s0022-5347(17)64066-7Takagi T, Go T, Takayasu H, Aso Y. Fiberoptic pyeloureteroscope. Surgery. 1971;70(5):661-3 passim. PMID: 5120887Takagi T, Go T, Takayasu H, Aso Y. Fiberoptic pyeloureteroscope. Surgery. 1971;70(5):661-3 passim. PMID: 5120887Bagley DH, Huffman JL, Lyon ES. Flexible ureteropyeloscopy: diagnosis and treatment in the upper urinary tract. J Urol. 1987;138(2):280-5. s://doi.org/10.1016/s0022-5347(17)43119-3Bagley DH, Huffman JL, Lyon ES. Flexible ureteropyeloscopy: diagnosis and treatment in the upper urinary tract. J Urol. 1987;138(2):280-5. s://doi.org/10.1016/s0022-5347(17)43119-3Johnson DE, Cromeens DM, Price RE. Use of the holmium:YAG laser in urology. Lasers Surg Med. 1992;12(4):353-63. https://doi.org/10.1002/lsm.1900120402Johnson DE, Cromeens DM, Price RE. Use of the holmium:YAG laser in urology. Lasers Surg Med. 1992;12(4):353-63. https://doi.org/10.1002/lsm.1900120402Grasso M, Conlin M, Bagley D. Retrograde ureteropyeloscopic treatment of 2 cm. or greater upper urinary tract and minor Staghorn calculi. J Urol. 1998;160(2):346-51. PMID: 9679874Grasso M, Conlin M, Bagley D. Retrograde ureteropyeloscopic treatment of 2 cm. or greater upper urinary tract and minor Staghorn calculi. J Urol. 1998;160(2):346-51. PMID: 9679874El-Anany FG, Hammouda HM, Maghraby HA, Elakkad MA. Retrograde ureteropyeloscopic holmium laser lithotripsy for large renal calculi. BJU Int. 2001;88(9):850-3. s://doi.org/10.1046/j.1464-4096.2001.01248.xEl-Anany FG, Hammouda HM, Maghraby HA, Elakkad MA. Retrograde ureteropyeloscopic holmium laser lithotripsy for large renal calculi. BJU Int. 2001;88(9):850-3. s://doi.org/10.1046/j.1464-4096.2001.01248.xMariani AJ. Combined electrohydraulic and holmium:YAG laser ureteroscopic nephrolithotripsy of large (greater than 4 cm) renal calculi. J Urol. 2007;177(1):168-73; discussion173. s://doi.org/10.1016/j.juro.2006.08.066Mariani AJ. Combined electrohydraulic and holmium:YAG laser ureteroscopic nephrolithotripsy of large (greater than 4 cm) renal calculi. J Urol. 2007;177(1):168-73; discussion173. s://doi.org/10.1016/j.juro.2006.08.066Breda A, Ogunyemi O, Leppert JT, Lam JS, Schulam PG. Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater--is this the new frontier? J Urol. 2008;179(3):981-4. s://doi.org/10.1016/j.juro.2007.10.083Breda A, Ogunyemi O, Leppert JT, Lam JS, Schulam PG. Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater--is this the new frontier? J Urol. 2008;179(3):981-4. s://doi.org/10.1016/j.juro.2007.10.083Hyams ES, Bruhn A, Lipkin M, Shah O. Heterogeneity in the reporting of disease characteristics and treatment outcomes in studies evaluating treatments for nephrolithiasis. J Endourol. 2010;24(9):1411-4. s://doi.org/10.1089/end.2009.0645Hyams ES, Bruhn A, Lipkin M, Shah O. Heterogeneity in the reporting of disease characteristics and treatment outcomes in studies evaluating treatments for nephrolithiasis. J Endourol. 2010;24(9):1411-4. s://doi.org/10.1089/end.2009.0645Al-Qahtani SM, Gil-Deiz-de-Medina S, Traxer O. Predictors of clinical outcomes of flexible ureterorenoscopy with holmium laser for renal stone greater than 2 cm. Adv Urol. 2012;2012:543537. s://doi.org/10.1155/2012/543537Al-Qahtani SM, Gil-Deiz-de-Medina S, Traxer O. Predictors of clinical outcomes of flexible ureterorenoscopy with holmium laser for renal stone greater than 2 cm. Adv Urol. 2012;2012:543537. s://doi.org/10.1155/2012/543537Cohen J, Cohen S, Grasso M. Ureteropyeloscopic treatment of large, complex intrarenal and proximal ureteral calculi. BJU Int. 2013;111(3 Pt B):E127-31. s://doi.org/10.1111/j.1464-410X.2012.11352.xCohen J, Cohen S, Grasso M. Ureteropyeloscopic treatment of large, complex intrarenal and proximal ureteral calculi. BJU Int. 2013;111(3 Pt B):E127-31. s://doi.org/10.1111/j.1464-410X.2012.11352.xMiernik A, Schoenthaler M, Wilhelm K, Wetterauer U, Zyczkowski M, Paradysz A, Bryniarski P. Combined semirigid and flexible ureterorenoscopy via a large ureteral access sheath for kidney stones >2 cm: a bicentric prospective assessment. World J Urol. 2014;32(3):697-702. s://doi.org/10.1007/s00345-013-1126-zMiernik A, Schoenthaler M, Wilhelm K, Wetterauer U, Zyczkowski M, Paradysz A, Bryniarski P. Combined semirigid and flexible ureterorenoscopy via a large ureteral access sheath for kidney stones >2 cm: a bicentric prospective assessment. World J Urol. 2014;32(3):697-702. s://doi.org/10.1007/s00345-013-1126-zPieras E, Tubau V, Brugarolas X, Ferrutxe J, Pizá P. Comparative analysis between percutaneous nephrolithotomy and flexible ureteroscopy in kidney stones of 2-3cm. Actas Urol Esp. 2017;41(3):194-199. English, Spanish. s://doi.org/10.1016/j.acuro.2016.08.005Pieras E, Tubau V, Brugarolas X, Ferrutxe J, Pizá P. Comparative analysis between percutaneous nephrolithotomy and flexible ureteroscopy in kidney stones of 2-3cm. Actas Urol Esp. 2017;41(3):194-199. English, Spanish. s://doi.org/10.1016/j.acuro.2016.08.005Huang JS, Xie J, Huang XJ, Yuan Q, Jiang HT, Xiao KF. Flexible ureteroscopy and laser lithotripsy for renal stones 2 cm or greater: A single institutional experience. Medicine (Baltimore). 2020;99(43):e22704. s://doi.org/10.1097/MD.0000000000022704Huang JS, Xie J, Huang XJ, Yuan Q, Jiang HT, Xiao KF. Flexible ureteroscopy and laser lithotripsy for renal stones 2 cm or greater: A single institutional experience. Medicine (Baltimore). 2020;99(43):e22704. s://doi.org/10.1097/MD.0000000000022704Geraghty R, Abourmarzouk O, Rai B, Biyani CS, Rukin NJ, Somani BK. Evidence for Ureterorenoscopy and Laser Fragmentation (URSL) for Large Renal Stones in the Modern Era. Curr Urol Rep. 2015;16(8):54. s://doi.org/10.1007/s11934-015-0529-3Geraghty R, Abourmarzouk O, Rai B, Biyani CS, Rukin NJ, Somani BK. Evidence for Ureterorenoscopy and Laser Fragmentation (URSL) for Large Renal Stones in the Modern Era. Curr Urol Rep. 2015;16(8):54. s://doi.org/10.1007/s11934-015-0529-3Erkoc M, Bozkurt M. Comparison of Mini-Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery for Renal Pelvic Stones of 2-3 cm. J Laparoendosc Adv Surg Tech A. 2021;31(6):605-609. s://doi.org/10.1089/lap.2020.0860Erkoc M, Bozkurt M. Comparison of Mini-Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery for Renal Pelvic Stones of 2-3 cm. J Laparoendosc Adv Surg Tech A. 2021;31(6):605-609. s://doi.org/10.1089/lap.2020.0860Xu Y, Lu Z, Lan Y, Wu D, Xiong L. Retrograde intrarenal surgery for a staghorn renal calculus in a patient with solitary kidney and urinary tract deformity: a case report. Transl Androl Urol. 2021;10(8):3532-3539. s://doi.org/10.21037/tau-21-192Xu Y, Lu Z, Lan Y, Wu D, Xiong L. Retrograde intrarenal surgery for a staghorn renal calculus in a patient with solitary kidney and urinary tract deformity: a case report. Transl Androl Urol. 2021;10(8):3532-3539. s://doi.org/10.21037/tau-21-192Karakoyunlu AN, Cakici MC, Sari S, Hepsen E, Ozok HU, Sagnak AL, Topaloglu H, Senturk AB, Ersoy H. Comparison of Retrograde Intrarenal Surgery and Percutaneous Nephrolithotomy Methods For Management of Big- Sized Kidney Stones(? 4 cm): Single Center Retrospective Study. Urol J. 2019;16(3):232-235. s://doi.org/10.22037/uj.v0i0.4072Karakoyunlu AN, Cakici MC, Sari S, Hepsen E, Ozok HU, Sagnak AL, Topaloglu H, Senturk AB, Ersoy H. Comparison of Retrograde Intrarenal Surgery and Percutaneous Nephrolithotomy Methods For Management of Big- Sized Kidney Stones(? 4 cm): Single Center Retrospective Study. Urol J. 2019;16(3):232-235. s://doi.org/10.22037/uj.v0i0.4072Atis G, Culpan M, Pelit ES, Canakci C, Ulus I, Gunaydin B, Yildirim A, Caskurlu T. Comparison of Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery in Treating 20-40 mm Renal Stones. Urol J. 2017;14(2):2995-2999. PMID: 28299761Atis G, Culpan M, Pelit ES, Canakci C, Ulus I, Gunaydin B, Yildirim A, Caskurlu T. Comparison of Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery in Treating 20-40 mm Renal Stones. Urol J. 2017;14(2):2995-2999. PMID: 28299761Bryniarski P, Paradysz A, Zyczkowski M, Kupilas A, Nowakowski K, Bogacki R. A randomized controlled study to analyze the safety and efficacy of percutaneous nephrolithotripsy and retrograde intrarenal surgery in the management of renal stones more than 2 cm in diameter. J Endourol. 2012;26(1):52-7. s://doi.org/10.1089/end.2011.0235Bryniarski P, Paradysz A, Zyczkowski M, Kupilas A, Nowakowski K, Bogacki R. A randomized controlled study to analyze the safety and efficacy of percutaneous nephrolithotripsy and retrograde intrarenal surgery in the management of renal stones more than 2 cm in diameter. J Endourol. 2012;26(1):52-7. s://doi.org/10.1089/end.2011.0235Palmero JL, Durán-Rivera AJ, Miralles J, Pastor JC, Benedicto A. Comparative study for the efficacy and safety of percutaneous nefhrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for the treatment of 2-3,5 cm kidney stones. Arch Esp Urol. 2016;69(2):67-72. English, Spanish. PMID: 26959965Palmero JL, Durán-Rivera AJ, Miralles J, Pastor JC, Benedicto A. Comparative study for the efficacy and safety of percutaneous nefhrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for the treatment of 2-3,5 cm kidney stones. Arch Esp Urol. 2016;69(2):67-72. English, Spanish. PMID: 26959965Hyams ES, Munver R, Bird VG, Uberoi J, Shah O. Flexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm: a multi-institutional experience. J Endourol. 2010;24(10):1583-8. s://doi.org/10.1089/end.2009.0629Hyams ES, Munver R, Bird VG, Uberoi J, Shah O. Flexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm: a multi-institutional experience. J Endourol. 2010;24(10):1583-8. s://doi.org/10.1089/end.2009.0629Yang E, Jing S, Niu Y, Qi S, Yadav PK, Yang L, Bao J, Tian J, Wang J, Li N, Ou T, Wang Z. Single-Use Digital Flexible Ureteroscopes as a Safe and Effective Choice for the Treatment of Lower Pole Renal Stones: Secondary Analysis of a Randomized-Controlled Trial. J Endourol. 2021;35(12):1773-1778. s://doi.org/10.1089/end.2021.0170Yang E, Jing S, Niu Y, Qi S, Yadav PK, Yang L, Bao J, Tian J, Wang J, Li N, Ou T, Wang Z. Single-Use Digital Flexible Ureteroscopes as a Safe and Effective Choice for the Treatment of Lower Pole Renal Stones: Secondary Analysis of a Randomized-Controlled Trial. J Endourol. 2021;35(12):1773-1778. s://doi.org/10.1089/end.2021.0170Dresner SL, Iremashvili V, Best SL, Hedican SP, Nakada SY. Influence of Lower Pole Infundibulopelvic Angle on Success of Retrograde Flexible Ureteroscopy and Laser Lithotripsy for the Treatment of Renal Stones. J Endourol. 2020;34(6):655-660. s://doi.org/10.1089/end.2019.0720Dresner SL, Iremashvili V, Best SL, Hedican SP, Nakada SY. Influence of Lower Pole Infundibulopelvic Angle on Success of Retrograde Flexible Ureteroscopy and Laser Lithotripsy for the Treatment of Renal Stones. J Endourol. 2020;34(6):655-660. s://doi.org/10.1089/end.2019.0720Auge BK, Dahm P, Wu NZ, Preminger GM. Ureteroscopic management of lower-pole renal calculi: technique of calculus displacement. J Endourol. 2001;15(8):835-8. s://doi.org/10.1089/089277901753205852Auge BK, Dahm P, Wu NZ, Preminger GM. Ureteroscopic management of lower-pole renal calculi: technique of calculus displacement. J Endourol. 2001;15(8):835-8. s://doi.org/10.1089/089277901753205852Bozzini G, Verze P, Arcaniolo D, Dal Piaz O, Buffi NM, Guazzoni G, Provenzano M, Osmolorskij B, Sanguedolce F, Montanari E, Macchione N, Pummer K, Mirone V, De Sio M, Taverna G. A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience : A better understanding on the treatment options for lower pole stones. World J Urol. 2017;35(12):1967-1975. s://doi.org/10.1007/s00345-017-2084-7Bozzini G, Verze P, Arcaniolo D, Dal Piaz O, Buffi NM, Guazzoni G, Provenzano M, Osmolorskij B, Sanguedolce F, Montanari E, Macchione N, Pummer K, Mirone V, De Sio M, Taverna G. A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience : A better understanding on the treatment options for lower pole stones. World J Urol. 2017;35(12):1967-1975. s://doi.org/10.1007/s00345-017-2084-7Koyuncu H, Yencilek F, Kalkan M, Bastug Y, Yencilek E, Ozdemir AT. Intrarenal Surgery vs Percutaneous Nephrolithotomy in the Management of Lower Pole Stones Greater than 2 cm. Int Braz J Urol. 2015;41(2):245-51. s://doi.org/10.1590/S1677-5538.IBJU.2015.02.09Koyuncu H, Yencilek F, Kalkan M, Bastug Y, Yencilek E, Ozdemir AT. Intrarenal Surgery vs Percutaneous Nephrolithotomy in the Management of Lower Pole Stones Greater than 2 cm. Int Braz J Urol. 2015;41(2):245-51. s://doi.org/10.1590/S1677-5538.IBJU.2015.02.09

The authors declare that there are no conflicts of interest present.