Background: Retrograde intrarenal surgery (RIRS) is widely used for renal calculi; however, a subset of patients require auxiliary procedures for complete stone clearance. Identifying predictors of such interventions is essential for preoperative counseling and surgical planning. Aim: To determine the incidence and predictors of auxiliary procedures following RIRS. Methods: A retrospective cohort study was conducted on 100 patients undergoing RIRS between April 2025 and March 2026 at a tertiary care center. Patients were divided into Group A (no auxiliary procedure) and Group B (required auxiliary procedure). Demographic, clinical, and stone-related variables were analyzed. Statistical tests included Chi-square and independent t-test, with p < 0.05 considered significant. Results: Out of 100 patients, 15 required auxiliary procedures (15%). Larger stone size, lower pole location, and higher stone density were significantly associated with auxiliary procedures (p < 0.05). Mean stone size in Group B was significantly higher (18.4 ± 3.2 mm vs 12.1 ± 2.8 mm). Lower pole stones were more common in Group B (60% vs 28%). Conclusion: Auxiliary procedures after RIRS are required in a minority of patients. Larger stone burden, lower pole location, and high stone density are important predictors.
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