[3]Retrograde Intrarenal Surgery (RIRS) and Percutan Nephrolithotomy (PCNL) are treatment options for kidney stones, but there is no Objectives: Kidney stones are treated with many methods, but there

The gap

Consensus across the literature

Supporting evidence — 4 representative gaps

• Efficacy, safety, and Outcomes of Retrograde Intrarenal Surgery for Upper Ureteric and Renal Stones: A Single-Center Retrospective Study of 382 Cases (2026) · doi

  single-centre design, which may bias selection. Procedures were performed by three experienced urologists, limiting generalisability. Stone composition was not uniformly analysed, and outcomes were not stratified by stone density or Hounsfield units. SFR was defined using USG KUB rather than non-contrast CT, possibly overestimating stone-free status, though CT in 81.9% of was used preoperatively patients. for Long-term recurrence and stricture is lacking. follow-up CONCLUSION RIRS with holmium laser lithotripsy is an effective and safe approach for treating upper ureteric and renal stones up to 3 cm, with a 92.5% stone-free rate, low incidence of major complications, and brief hospital stays. These findings are consistent with recent studies and endorse RIRS as a primary minimally invasive option for moderate-sized upper tract stones. Future to research prospective categorize outcomes based on stone composition long-term and recurrence. should assess aim REFERENCES 1. Romero V, Akpinar H, Assimos DG. 2. 3. 4. Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Rev Urol. 2010;12(2-3):e86-96. Scales CD Jr, Smith AC, Hanley JM, Saigal CS. Prevalence of kidney stones in the United States. Eur Urol. 2012;62(1):160-5. Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, et al. EAU guidelines on diagnosis and conservative management of urolithiasis. Eur Urol. 2016;69(3):468-74. Skolarikos A, Neisius A, Petřík A, Somani B, Thomas K, Gambaro G, et al. EAU guidelines on urolithiasis. Arnhem: European Association of Urology; 2024. 5. Assimos D, Krambeck A, Miller NL, 6. Monga M, Murad MH, Nelson CP, et al. Surgical management of stones: American Urological Association/Endourological Society guideline, part I. J Urol. 2016;196(4):1153-60. Srisubat A, Potisat S, Lojanapiwat B, Setthawong V, Laopaiboon M.

  Keywords: stone stones urol composition outcomes free long term recurrence rirs upper incidence assimos kidney prevalence
• Supine mini-PCNL using pneumatic lithotripsy for pediatric renal stones: safety and efficacy in low-income countries (2026) · doi

  Our study’s primary limitation is its single-center design, which may limit the generalizability of our findings. Future research should include larger, multi-center trials with extended follow-up periods to assess long-term renal func- tion and potential complications. Additionally, the study focused exclusively on solitary stones within a specific size range (10–25 mm); therefore, the comparative efficacy of pneumatic versus laser lithotripsy in cases of complex or staghorn calculi remains to be determined.

  Keywords: center primary limitation single design limit generalizability future include larger multi trials extended follow periods
• Percutaneous nephrolithotomy among patients with upper urinary system anomalies: evaluating the prevalence, types, characteristics and comparing its outcomes with other patients: a prospective, comparative study of 1485 patients (2026) · doi

  This study has several limitations. First, it was conducted at a single tertiary referral center, which may limit generaliz- ability—particularly since such centers may encounter more complex stone disease. Second, although prospective data collection improves reliability, this study design remains observational and cannot establish causality. Third, follow- up imaging for stone-free assessment was based on KUB and selective delayed ultrasonography rather than uniform non-contrast CT, which may underestimate small residual fragments. Fourth, some anomaly subgroups (e.g., horse- shoe kidney, infundibular stenosis) had limited sample sizes, restricting the power for subgroup analysis. Finally, techni- cal variations between surgeons—although minimized in a specialized center—could have contributed to differences in outcomes. Differences in skill between surgeons are accept- able and not included in this study. We acknowledge that some of these anomalies may be considered anatomical variants with limited clinical impact on PCNL outcomes. We are aware of the differences between methods of SFR evaluation. Heterogeneity in imaging modalities is a limita- tion but the reasons for this are the conditions of patients’ access to various imaging methods and the consideration of minimum additional costs. There was lack of blinding in our study.

  Keywords: imaging differences center stone limited surgeons outcomes several limitations first conducted single tertiary referral limit
• In the Treatment of Lower Pole Kidney Stones Between 1-2 cm in Children, Which is the Best Approach? Retrograde Intrarenal Surgery or Mini Percutaneous Nephrolithotomy (2024) · doi

  [3]Retrograde Intrarenal Surgery (RIRS) and Percutan Nephrolithotomy (PCNL) are treatment options for kidney stones, but there is no Objectives: Kidney stones are treated with many methods, but there is no consensus on which method should be preferred for 1-2 cm lower renal stones.

  Keywords: stones kidney there retrograde intrarenal surgery rirs percutan nephrolithotomy pcnl treatment options objectives treated consensus