International Alliance of Urolithiasis guideline on retrograde intrarenal surgery

Guohua Zeng, Olivier Traxer, Wen Zhong, Palle Osther, Margaret S. Pearle, Glenn M. Preminger, Giorgio Mazzon, Christian Seitz, Petrisor Geavlete, Cristian Fiori, Khurshid R. Ghani, Ben H. Chew, Kah Ann Git, Fabio Carvalho Vicentini, Athanasios Papatsoris, Marianne Brehmer, Juan Lopez Martinez, Jiwen Cheng, Fan Cheng, Xiaofeng GaoNariman Gadzhiev, Amelia Pietropaolo, Silvia Proietti, Zhangqun Ye, Kemal Sarica

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


Objectives: To set out the second in a series of guidelines on the treatment of urolithiasis by the International Alliance of Urolithiasis that concerns retrograde intrarenal surgery (RIRS), with the aim of providing a clinical framework for urologists performing RIRS. Materials and Methods: After a comprehensive search of RIRS-related literature published between 1 January 1964 and 1 October 2021 from the PubMed database, systematic review and assessment were performed to inform a series of recommendations, which were graded using modified GRADE methodology. Additionally, quality of evidence was classified using a modification of the Oxford Centre for Evidence-Based Medicine Levels of Evidence system. Finally, related comments were provided. Results: A total of 36 recommendations were developed and graded that covered the following topics: indications and contraindications; preoperative imaging; preoperative ureteric stenting; preoperative medications; peri-operative antibiotics; management of antithrombotic therapy; anaesthesia; patient positioning; equipment; lithotripsy; exit strategy; and complications. Conclusion: The series of recommendations regarding RIRS, along with the related commentary and supporting documentation, offered here should help provide safe and effective performance of RIRS.

Original languageEnglish (US)
JournalBJU international
StateAccepted/In press - 2022


  • #EndoUrology
  • #KidneyStones
  • #UroStone
  • flexible ureteroscopy
  • guideline
  • retrograde intrarenal surgery
  • RIRS
  • treatment
  • urolithiasis

ASJC Scopus subject areas

  • Urology


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