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Abstract : Retrograde Intrarenal Surgery (RIRS) is an emerging minimally invasive method in the surgical treatment of kidney stones. It has rapidly become a preferred surgical technique owing minimally invasive surgical modality gap for small stones. The technique requires the simultaneous and effective use of laser energy, fluoroscopy, access sheaths, fiberoptic and digital technologies. The increasing experience with RIRS has created a tendency to simplify this complex process. There are several studies revealing that RIRS can be performed safely and effectively without these complex processes. Therefore the primary aims are to detect the safety and efficacy of the primary RIRS. From January 2022 to September 2022, the medical records of 58 patients who underwent RIRS for renal stones at Duhok hospitals prospectively evaluated. RIRS cases with stone sizes less than 25 mm and adult age group > 18 years with prior unstented ureters were included. Pediatric age patients, multi-stage procedures, documented ureteral strictures were excluded. Stone clearance rate; at the first session were 40 cases (68.97%) and at the Second session were 18 cases (31.03%). Complication rates; urosepsis 8 cases (13.79%), Ureteral contusion 4 cases (6.90%), and gross hematuria 4 cases (6.90%). The use of primary RIRS in unstented prior ureter is generally effective and safe and is not associated with higher complication rate.

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