Introduction
Since retrograde intrarenal surgery (RIRS) was first defined in the
1990s, there have been improvements concerning this technique [1,2].
With the development of flexible endoscopes (miniaturization of
endoscopes and improvement in image quality), increase in the quality of
light sources, and advances in the lithotripsy technology, RIRS has
become the first treatment option for upper urinary tract stones of
<2 cm [3,4]. In parallel to these developments, the
treatment of proximal ureteral and renal stones has undergone a
significant change in recent years. In a systemic review, the total
stone-free rate was reported as 91% and the major complication rate
(Clavien ≥3) as 4.5% in an average of 1.45 procedures in patients who
underwent RIRS due to having renal stones of >2 cm
[5,6]. Although there are large series in the literature
investigating the complications of semirigid ureteroscopy [7,8],
only a limited number of studies have been conducted to evaluate RIRS
complications in large series. Some scoring systems have been defined
for grading surgical complications. Among these, the modified Clavien
classification system (MCCS) is most commonly used for postoperative
complications, and the modified Satava classification system (SCS) is
employed to classify intraoperative complications and events [9,10].
Complication classification systems are important because they can
easily demonstrate the safety of the surgery and also create
standardization to compare results obtained from different centers. In
addition, determining parameters associated with complications and
predicting complication development are as important as achieving
stone-free status, which is considered to indicate the success of
surgery.
In this study, we aimed to classify intraoperative and postoperative
complications in patients undergoing RIRS using MCCS and SCS and to
evaluate complication-related parameters.