International Alliance of Urolithiasis guideline on retrograde intrarenal surgery

Zeng G 1 , Traxer O 2 , Zhong W 1 , Osther P 3 , Pearle MS 4 , Preminger GM 5 Show all authors , Mazzon G 6 , Seitz C 7 , Geavlete P 8 , Fiori C 9 , Ghani KR 10 , Chew BH 11 , Git KA 12 , Vicentini FC 13 , Papatsoris A 14 , Brehmer M 15 , Martinez JL 16 , Cheng J 17 , Cheng F 18 , Gao X 19 , Gadzhiev N 20 , Pietropaolo A 21 , Proietti S 22 , Ye Z 23 , Sarica K 24

Affiliations 

  • 1 Department of Urology, Guangdong Key Laboratory of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
  • 2 GRC Urolithiasis No. 20, Sorbonne University, Tenon Hospital, Paris, France
  • 3 Department of Urology, Vejle Hospital-a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
  • 4 University of Texas Southwestern Medical Center, Dallas, TX, USA
  • 5 Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA
  • 6 Department of Urology, San Bassiano Hospital, Vicenza, Italy
  • 7 Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
  • 8 Sanador Hospital, Bucharest, Romania
  • 9 Division of Urology, Department of Oncology, University of Turin, Turin, Italy
  • 10 Department of Urology, University of Michigan, Ann Arbor, MI, USA
  • 11 Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
  • 12 Department of Urology, Pantai Hospital, Penang, Malaysia
  • 13 Departamento de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, Hospital das Clínicas, São Paulo, Brazil
  • 14 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece
  • 15 Division of Urology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
  • 16 Department of Urology, Clinic Hospital, University of Barcelona, Barcelona, Spain
  • 17 Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
  • 18 Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
  • 19 Department of Urology, Changhai Hospital, Shanghai, China
  • 20 Department of Urology, Saint-Petersburg State University Hospital, Saint-Petersburg, Russia
  • 21 Department of Urology, University Hospital Southampton, Southampton, UK
  • 22 Department of Urology, IRCCS San Raffaele Hospital, Milan, Italy
  • 23 Department of Urology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
  • 24 Department of Urology, Medical School, Biruni University, Istanbul, Turkey
BJU Int, 2023 Feb;131(2):153-164.
PMID: 35733358 DOI: 10.1111/bju.15836

Abstract

OBJECTIVES: To set out the second in a series of guidelines on the treatment of urolithiasis by the International Alliance of Urolithiasis that concerns retrograde intrarenal surgery (RIRS), with the aim of providing a clinical framework for urologists performing RIRS.

MATERIALS AND METHODS: After a comprehensive search of RIRS-related literature published between 1 January 1964 and 1 October 2021 from the PubMed database, systematic review and assessment were performed to inform a series of recommendations, which were graded using modified GRADE methodology. Additionally, quality of evidence was classified using a modification of the Oxford Centre for Evidence-Based Medicine Levels of Evidence system. Finally, related comments were provided.

RESULTS: A total of 36 recommendations were developed and graded that covered the following topics: indications and contraindications; preoperative imaging; preoperative ureteric stenting; preoperative medications; peri-operative antibiotics; management of antithrombotic therapy; anaesthesia; patient positioning; equipment; lithotripsy; exit strategy; and complications.

CONCLUSION: The series of recommendations regarding RIRS, along with the related commentary and supporting documentation, offered here should help provide safe and effective performance of RIRS.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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