Abstract Background: Retrograde intrarenal surgery (RIRS) is an established treatment for upper urinary tract calculi; however, postoperative complications may occasionally occur. It has been hypothesized that renal cooling-induced vasoconstriction during RIRS may reduce the risk of complications and postoperative infections. This study aimed to evaluate this hypothesis by comparing complication rates associated with cold normal saline (NS) irrigation versus room-temperature NS irrigation during RIRS. Materials and Methods: A prospective analysis was conducted on 40 patients undergoing RIRS for renal stones smaller than 1.5 cm at MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India. Patients were randomized using the chit-box technique into two equal groups ( n = 20 each): the room-temperature group, in which intraoperative irrigation was performed with saline at 24°C, and the cold group, in which saline was cooled to 4°C. Results: Postoperative complications were significantly lower in the cold group than in the room-temperature group. In the room-temperature group, 3 (15%) patients developed postoperative fever, and 2 (10%) patients developed capsular hematoma on follow-up. No patient in either group experienced significant hematuria. Hospital stay was shorter in the cold group, which also demonstrated better postoperative outcomes, including lower pain scores. Conclusion: These findings suggest that intraoperative irrigation with cold saline during RIRS may reduce postoperative complication rates, improve pain outcomes, and shorten hospital stay compared with room-temperature saline irrigation.
Gawali et al. (Thu,) studied this question.