Successful retrograde intrarenal surgery (RIRS) for a 2-centimeter stone in a chronic renal failure (CRF) patient

INTRODUCTION AND IMPORTANCE: Retrograde intrarenal surgery (RIRS) is the best complementary method to Flexible Ureterorenoscopy (URF). In the case of renal insufficiency in patients with urolithiasis, the stone treatment strategy can be different because it should have the least injury to the kidney and be minimally invasive. There was no previous evidence of RIRS in stone-breaking in a chronic renal failure (CRF) patient. For the first time, we presented a successful RIRS in the monokidney CRF case with >2 cm stone. CASE PRESENTATION: We have done the RIRS over a 55-year-old monokidney woman. She already has lymphoma, chemotherapy, lithotripsy, right renal nephrostomy, and a left kidney stone removal. She had hydronephrosis with a >2 cm stone in her left kidney. The patient underwent RIRS surgery and Holmium lithotripsy (strength 8 and impact strength 13,000) on pinking layers of stone. CLINICAL DISCUSSION: During the RIRS surgery, we put a ureteric stent (the patient already had a double J before), and we fixed the ureteral catheter with the Foley catheter and removed the ureteral catheter 4 days after the surgery. The result of the surgery was satisfying and after three days the patient goes into a stable condition. CONCLUSION: Regarding the least injury to the kidney during RIRS surgery, it can be the best treatment option for urolithiasis in CRF patients.