Endoscopic combined intrarenal surgery in treatment of a female patient with multiple stones in the right kidney

Endoscopic combined intrarenal surgery (ECIRS) was first performed in 2008 and consisted of simultaneous antegrade and retrograde approaches to the kidney. ECIRS combines two techniques: percutane nephrolithotripsy and retrograde intrarenal surgery.
We present the experience of treating a female patient with multiple concrements of the right kidney.
Objective. To evaluate the efficacy and safety of endoscopic combined intrarenal surgery (ECIRS) using a stone-free rate and complication rate by the Clavien-Dindo classification on the basis of the presented clinical study.
Material and methods. Patient B., 66 years old, was admitted to the Urology Unit No. 1 of the Regional Clinical Hospital No. 2 (Krasnodar, Russian Federation) with dragging pain in the lumbar region on the right side and a nephrostomy tube on the right. She underwent a complex of laboratory and imaging studies. The surgery was performed under spinal anesthesia. The patient was placed on the operating table in the Galdakao-modified supine Valdivia position and underwent ECIRS on the right side (percutaneous nephrolithotomy with stone extraction + retrograde intrarenal surgery) and nephrostomy and ureteral stenting on the right side. The postoperative period went smoothly, and the patient had no complications according to the Clavien-Dindo classification. Follow-up computed tomography showed no stones in the urinary system.
Conclusions. ECIRS is an updated, complete, and versatile version of percutaneous nephrolithotomy, which is a leading method in endourology and can be considered the new gold standard for treatment of patients with multiple kidney stones or staghorn nephrolithiasis. ECIRS allows for personalized stone management.

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