Volume 3, 2022



Nikolay Mirinchev and Zlatka Cholakova
Pages: 68-75

ABSTRACT: Introduction: Worldwide, kidney stone disease (KSD) represents a significant burden on health systems. Operative approaches are evolving very rapidly and aim to reduce the invasiveness of procedures while ensuring a stone free rate (SFR). Retrograde intrarenal surgery (RIRS) is a fully endoscopic and minimally invasive type of surgery. Performing RIRS presents a unique challenge due to the narrowness of the operative field, the great anatomical diversity of each pyelo-calyx system, the complexity of the operative maneuvers, the fragility of the special instruments and the potentially severe complications.
Therefore, achieving adequate proficiency with RIRS can be a difficult task.
Purpose: The purpose of our article is to show interesting cases in our clinical practice and how we deal with challenges in endourology.
Tasks and methods: For a period of 3 years, some of the more interesting and professionally challenging cases were examined. Patient evaluation included medical history, physical examination, urinalysis, urinalysis, complete blood count, serum biochemistry, coagulation test. CT(computer tomography) was performed preoperatively and followed up postoperatively by overview radiography and ultrasonography. A respiratory and cardiovascular evaluation (chest radiography and electrocardiogram) was performed.
All patients were treated with minimally invasive modern methods.
Results: In all included clinical cases, an excellent therapeutic result was achieved within the postoperative one-year follow-up of each patient. No early or late complications were observed.
Conclusion: With the improvement of imaging methods for diagnosis and treatment, the miniaturization of working elements, the introduction of new technologies and designs for additional instruments, minimally invasive urology, in particular retrograde intrarenal surgery (RIRS), successfully copes with more and more interesting clinical cases and challenges.
Key words: kidney stone disease, RIRS (retrograde intrarenal surgery), kidney stone disease (KSD), ureteroscopy(URS), endourology.


Keywords: prostate biopsy, multiparametric magnetic resonance, prostate carcinoma, fusion biopsy, prostate specific antigen


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