Mini-Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for Solitary 1-2 cm Renal Stones: A Quasi-Experimental Comparative Study

Ajmal Khan Jogezai; Qamar Zia; Ajmal Kakar; Muhammad Tahir; Farhaad Tareen; Naseer Ahmed

doi:10.51253/pafmj.v76iSUPPL-8.14578

Authors

Ajmal Khan Jogezai Department of Urology, Armed Forces Institute of Urology Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Qamar Zia Department of Urology, Armed Forces Institute of Urology Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Ajmal Kakar Department of Urology, Armed Forces Institute of Urology Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Muhammad Tahir Department of Urology, Armed Forces Institute of Urology Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Farhaad Tareen Department of Urology, Armed Forces Institute of Urology Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Naseer Ahmed Department of Urology, Armed Forces Institute of Urology Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-8.14578

Keywords:

Hospital Stay; Kidney Calculi; Nephrolithiasis; Percutaneous Nephrolithotomy; Postoperative Pain; Retrograde Intrarenal Surgery; Stone-Free Rate; Treatment Outcome; Ureteroscopy

Abstract

Objective: To compare the efficacy and safety of Mini-Percutaneous Nephrolithotomy (Mini-PCNL) and Retrograde Intrarenal Surgery (RIRS) for solitary renal stones measuring 1-2 cm.

Study Design: Quasi-experimental study.

Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, conducted from Oct 2025 to Jan 2026.

Methodology: A total of 100 patients were enrolled by non-probability consecutive sampling and allocated to Mini-PCNL (n=50) or RIRS (n=50). Eligible patients were adults aged 18-60 years with a solitary 1-2 cm renal stone. Stone-free rate at four weeks, operative time, hospital stay, postoperative pain, and complications were compared between groups.

Results: Mini-PCNL achieved a higher stone-free rate than RIRS (90.0% vs. 74.0%, p=0.037) and had a shorter operative time (68.4 ± 15.2 min vs. 85.7 ± 20.2 min, p<0.001). RIRS was associated with a shorter hospital stay (median 3.35 [IQR 3.00–3.88] days vs. 4.57 [4.01–4.97] days, p<0.001) and lower pain scores on postoperative days 1 and 2 (p<0.001). Overall complication rates were comparable (24.0% vs. 20.0%, p=0.629).

Conclusion: Mini-PCNL provided better stone clearance and shorter operative time, whereas RIRS offered less postoperative pain and shorter hospitalization. Procedure selection should be individualized according to clinical priorities and patient preference.

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