Evaluation of Renal Injury After RIRS Using Shear-Wave Elastography

Experimental: Aspiration-assisted ureteral access sheath

Patients will undergo retrograde intrarenal surgery using an aspiration-assisted ureteral access sheath.

Dispositivo: Aspiration-assisted ureteral access sheath

Patients undergoing retrograde intrarenal surgery using an aspiration-assisted ureteral access sheath

Comparador activo: Standard ureteral access sheath

Patients will undergo retrograde intrarenal surgery using a standard ureteral access sheath.

Dispositivo: Standard ureteral access sheath

Standard ureteral access sheath used during retrograde intrarenal surgery.

Renal Cortical Shear-Wave Elastography Values (kPa)

Renal cortical stiffness will be quantitatively evaluated using ultrasound-based shear-wave elastography. Measurements will be obtained from multiple regions of the renal cortex, and the mean value of these measurements will be recorded in kilopascals (kPa). All examinations will be performed using the same ultrasound device and standardized protocol by a single experienced radiologist blinded to the study groups.

Postoperative Complications

Perioperative and postoperative complications assessed according to the Clavien-Dindo classification system.

Serum Creatinine Level

Serum creatinine levels measured to evaluate renal function changes following retrograde intrarenal surgery.

Postoperative Fever and Sepsis

Occurrence of postoperative fever (>38°C) and/or sepsis following surgery.

Stone-Free Rate

Stone-free status assessed by postoperative imaging.

Renal Resistive Index

Renal resistive index values measured using Doppler ultrasonography to evaluate renal vascular resistance following retrograde intrarenal surgery.

Mayo Adhesive Probability Score

Perinephric fat adhesion severity assessed using the Mayo Adhesive Probability (MAP) Score based on preoperative computed tomography findings. The MAP Score ranges from 0 to 5, with higher scores indicating a greater likelihood of adherent perinephric fat and increased surgical complexity.

Postoperative Pain Scores

. Postoperative pain intensity was assessed using the Visual Analogue Scale (VAS), a 10-point scale ranging from 0 to 10, where 0 indicates no pain and 10 represents the most severe pain imaginable. Higher scores indicate greater pain intensity.