Retrograde Intrarenal Surgery: Analysis of Efficacy, Safety and Cost-Effectiveness of drug preparation

Krutskikh E.Yu., Dutov S.V., Andronov A.S., Martov A.G.

1) Medical and Biological Unit for Research and Education, Federal State Budgetary Institution «A.I. Burnazyan Federal Medical Biophysical Center» of FMBA of Russia, Moscow, Russia; 2) Lomonosov Moscow State University Medical Research and Educational Center, Moscow, Russia; 3) Federal State Budgetary Institution «Central Clinical Hospital of Civil Aviation», Moscow, Russia; 4) Research and Education Unit, Federal State Budgetary Educational Institution of Higher Education «ROSBIOTECH», Moscow, Russia

Introduction. Retrograde intrarenal surgery (RIRS) is the optimal treatment for kidney stones of 5–20 mm, but the success of the intervention depends on providing access through the ureter. Traditional preoperative stenting is accompanied by stent-associated symptoms that worsen patients’ quality of life. Objective. Comprehensive assessment of the efficacy, safety feasibility of using Omnic Ocas for drug preparation of the ureter for RIRS. Material and methods. A prospective single-center study of 58 patients divided into groups: receiving Omnic Ocas 0.4 mg/day (n=29) and prestenting group (n=29). Intra- and postoperative parameters were evaluated. Additionally, a systematic review of 10 RCTs (n=1624) was performed. Results. In the local study, the frequency of successful ureteral access sheath installation was comparable between groups (87% vs 92%, p>0.05). The Omnic Ocas group showed significantly better pain scores (3.2±1.1 vs 5.9±1.6 points, p<0.001), need for analgesics and quality of life according to the USSQ questionnaire (22.5±5.7 vs 34.8±7.3 points, p<0.001). Systematic review confirmed the advantages of tamsulosin over no preparation and comparable efficacy with prestenting with better tolerability. Conclusion. Drug preparation with Omnic Ocas is not inferior to prestenting in efficacy, but superior in tolerability and economic feasibility, being a preferred alternative.

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About the Authors

Corresponding author: E.Yu. Krutskikh – Resident, Department of Urology and Andrology, Medical and Biological Unit for Research and Education, Federal State Budgetary Institution «A.I. Burnazyan Federal Medical Biophysical Center» of FMBA of Russia, Moscow, Russia; e-mail: ekaterinka.krutskikh@mail.ru

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