PPS-RIRS: A Conceptual Framework for Harm-Aware and Physiology-Informed Retrograde Intrarenal Surgery (Version 1.0)

PPS-RIRS Version 1.0 is an evidence-informed, hypothesis-generating conceptual framework that proposes evaluating retrograde intrarenal surgery through three complementary dimensions: stone clearance, functional preservation and procedural harm. The framework separates baseline patient vulnerability, procedural exposure, adaptive intraoperative control and clinical outcomes. Intrarenal pressure, thermal load, mechanical trauma and infectious hazard are proposed as core procedural exposure domains, with procedural duration acting as a potential amplifier. This Version 1.0 record defines suggested scope, terminology, architecture and proposed developmental pathway of PPS-RIRS. It contains no patient-level data, expert-survey results, validated numerical score, empirically derived weighting, risk thresholds or claims of clinical effectiveness. The proposed next stages comprise independent expert content review, prospective feasibility testing, empirical development of measurable procedural-harm variables, external validation and subsequent evaluation of clinical utility.