ArticleWorld journal of urology2023
Indications, preferences, global practice patterns and outcomes in retrograde intrarenal surgery (RIRS) for renal stones in adults: results from a multicenter database of 6669 patients of the global FLEXible ureteroscopy Outcomes Registry (FLEXOR).
Article in World journal of urology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 1 of them a synthesis that pooled it.
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Who cites it
48 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- Rethinking high-frequency lithotripsy: a review by EAU endourology group.World journal of urology · 2026Pooled it
- Stone extraction during flexible ureterorenoscopy with or without the hydrogel method: a randomized, multicenter safety and feasibility study.World journal of urology · 2025Trial
- Is flexible navigable suction ureteral access sheath (FANS) safer and more efficient than conventional sheaths? Italian multicentric experience.World journal of urology · 2025Trial
- In vitro performance of the Vortex Intelligent Stone Optimized Removal (VISOR) system versus the flexible and navigable suction ureteral access sheath (FANS) on stone clearance efficiency and intrarenal pressure control.World journal of urology · 2026Article
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- Article
- Parameter mapping for the use of flexible and navigable suction sheath: an in vitro study.Urolithiasis · 2026Article
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- Comparison of Flexible and Navigable Suction Ureteral Access Sheath Versus Conventional Ureteric Access Sheath in RIRS: A Systematic Review and Meta-Analysis.Urology research & practice · 2026Article
- Management of nephrolithiasis in pelvic kidneys: comparative outcomes of contemporary surgical modalities from 11 high-volume centers.World journal of urology · 2026Article
- A novel nomogram for predicting stone-free status after retrograde intrarenal surgery in patients with kidney stones.BMC urology · 2025Article
- Iatrogenic upper urinary tract injuries during ureteroscopy for urolithiasis: a comprehensive review on incidence, mechanisms and preventative strategies.Nature reviews. Urology · 2025Review
- First in-vivo multicenter experience with the novel CVAC 2.0 ureteroscope with simultaneous irrigation and aspiration functionality.World journal of urology · 2025Article
- Lasing strategy and its influence on 30-day operative outcomes in flexible ureteroscopy with FANS: inferences from a real-world prospective multicenter study by EAU-endourology and AUSET.World journal of urology · 2025Article
- Outcomes of retrograde intrarenal surgery in patients on anticoagulant or antiplatelet therapy: a multicenter matched case-control study by the RIRSearch Study Group.World journal of urology · 2025Article
- The Role of Inflammatory Biomarkers in Predicting Postoperative Fever Following Flexible Ureteroscopy.Medicina (Kaunas, Lithuania) · 2025Article
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- Flexible ureteroscopy for renal stones comparing non suction conventional UAS vs flexible and navigable suction ureteral access sheaths in a multicenter real-world experience. Is it finally time to bury the no suction ureteral access sheath? An EAU endourology analysis.World journal of urology · 2025Article
- Impact of suction ureteral access sheath in ureteroscopy/retrograde intrarenal surgery: a systematic review and meta-analysis.Translational andrology and urology · 2025Article
- Predictors and associations of complications in ureteroscopy for stone disease using AI: outcomes from the FLEXOR registry.Urolithiasis · 2025Article
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Authors and funding
28 authors at 19 institutions in 16 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo collect a multicentric database on behalf of TOWER research group to assess practice patterns and outcomes of retrograde intrarenal surgery (RIRS) for kidney stones.
methodsInclusion criteria: age ≥ 18 years, normal renal/calyceal system anatomy, calculi of any size, number, and position. STUDY PERIOD: January 2018 and August 2021. Stone-free status: absence of fragments > 2 mm, assessed post procedure according to the local protocol (KUB X-Ray and/or ultrasound or non-contrast CT scan).
resultsTwenty centers from fifteen countries enrolled 6669 patients. There were 4407 (66.2%) men. Mean age was 49.3 ± 15.59 years. Pain was the most frequent symptom indication for intervention (62.6%). 679 (10.2%) patients underwent RIRS for an incidental finding of stones. 2732 (41.0%) patients had multiple stones. Mean stone size was 10.04 ± 6.84 mm. A reusable flexible ureteroscope was used in 4803 (72.0%) procedures. A sheath-less RIRS was performed in 454 (6.8%) cases. Holmium:YAG laser was used in 4878 (73.1%) cases. A combination of dusting and fragmentation was the most common lithotripsy mode performed (64.3%). Mean operation time was 62.40 ± 17.76 min. 119 (1.8%) patients had an intraoperative injury of the ureter due to UAS insertion. Mean postoperative stay was 3.62 ± 3.47 days. At least one postoperative complication occurred in 535 (8.0%) patients. Sepsis requiring intensive care admission occurred in 84 (1.3%) patients. Residual fragments were detected in 1445 (21.7%) patients. Among the latter, 744 (51.5%) patients required a further intervention.
conclusionOur database contributes real-world data to support to a better understanding of modern RIRS practice and outcomes.
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