Comparative Analysis of Super-Mini Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery for the Management of Renal Calculi ≤2 cm Among Somali Population

Background Limited data have explored the efficacy of Super-Mini Percutaneous Nephrolithotomy (SMP) and Retrograde intrarenal Surgery (RIRS) in managing≤ 2 cm renal calculi. This study aims to comprehensively evaluate the safety and effectiveness of SMP compared to RIRS. Method This prospective cohort study investigated 210 patients with renal calculi (≤ 2 cm) undergoing SMP or RIRS, randomly recruited over four years. 51.4% underwent SMP and 48.6% underwent RIRS. Results: The mean patient age was 31.3±14.7 years; 56.7% were men, mean stone size of 1.3±0.28 cm, and stone hardness of 1190.1±352.83 HU. Pearson's correlation indicated negative correlations for SMP with hospital stays (r=-0.138, p=0.046), operating time (r=-0.519, p<0.001), stone-free rate (SFR) (r=-0.161, p=0.020); and a positive correlation with a postoperative ureteral catheter (r=+0.389, p<0.001). In regards to RIRS, the study shows a positive correlation with hospital stay (r=+0.138, p=0.046), operating time (r=+0.519, p<0.001), and SFR (r=+0.161, p=0.020); and a negative correlation with postoperative ureteral catheter (r=-0.389, p<0.001). Logistic regression, using SMP as the reference, RIRS was associated with β=+0.31, and 1.20(95% CI,1.14-1.27, p=<0.001) risk of operation duration and β=+0.37, 1.44(95% CI,1.00-2.07, p=0.047) risk of longer hospital stay. Conclusion This study investigates the suitability of SMP and RIRS for treating renal calculi ≤2 cm. SMP demonstrated superior efficacy with significantly shorter operating times and reduced hospital stays, suggesting potential advantages for managing lower-volume renal stones.