Management of complex renal stones in horseshoe kidney using real-time intrarenal pressure monitoring with artificial intelligence in retrograde intrarenal surgery: A case report

Armand Achmadsyah; Favian Ariiq Rahmat; Nadhif Faza Ananda; Mukhlis Akmal Taher; Gerhard Reinaldi Situmorang; Widi Atmoko; Nur Rasyid; Ponco Birowo

doi:10.1016/j.eucr.2026.103366

Management of complex renal stones in horseshoe kidney using real-time intrarenal pressure monitoring with artificial intelligence in retrograde intrarenal surgery: A case report

Armand Achmadsyah
, Favian Ariiq Rahmat
, Nadhif Faza Ananda
, Mukhlis Akmal Taher
, Gerhard Reinaldi Situmorang
, Widi Atmoko
, Nur Rasyid
, Ponco Birowo

Research output: Contribution to journal › Article › peer-review

Abstract

Retrograde intrarenal surgery (RIRS) in horseshoe kidneys is technically challenging due to altered anatomy and unstable intrarenal pressure (IRP). We report a case of a 45-year-old male with complex renal stones in a horseshoe kidney managed using artificial intelligence (AI)-assisted real-time IRP monitoring during RIRS. The AI system dynamically regulated irrigation and suction to maintain IRP within a safe range (∼30 mmHg), improving intraoperative visibility and procedural control. Stone clearance was achieved without complications. This case highlights the feasibility and potential safety benefits of AI-assisted IRP monitoring in anatomically complex kidneys.

Original language	English
Article number	103366
Journal	Urology Case Reports
Volume	65
DOIs	https://doi.org/10.1016/j.eucr.2026.103366
Publication status	Published - Mar 2026

Keywords

Artificial intelligence
Complex renal stones
Horseshoe kidney
Intrarenal pressure
retrograde intrarenal surgery

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10.1016/j.eucr.2026.103366

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Achmadsyah, A., Rahmat, F. A., Ananda, N. F., Taher, M. A., Situmorang, G. R., Atmoko, W., Rasyid, N., & Birowo, P. (2026). Management of complex renal stones in horseshoe kidney using real-time intrarenal pressure monitoring with artificial intelligence in retrograde intrarenal surgery: A case report. Urology Case Reports, 65, Article 103366. https://doi.org/10.1016/j.eucr.2026.103366

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title = "Management of complex renal stones in horseshoe kidney using real-time intrarenal pressure monitoring with artificial intelligence in retrograde intrarenal surgery: A case report",

abstract = "Retrograde intrarenal surgery (RIRS) in horseshoe kidneys is technically challenging due to altered anatomy and unstable intrarenal pressure (IRP). We report a case of a 45-year-old male with complex renal stones in a horseshoe kidney managed using artificial intelligence (AI)-assisted real-time IRP monitoring during RIRS. The AI system dynamically regulated irrigation and suction to maintain IRP within a safe range (∼30 mmHg), improving intraoperative visibility and procedural control. Stone clearance was achieved without complications. This case highlights the feasibility and potential safety benefits of AI-assisted IRP monitoring in anatomically complex kidneys.",

keywords = "Artificial intelligence, Complex renal stones, Horseshoe kidney, Intrarenal pressure, retrograde intrarenal surgery",

author = "Armand Achmadsyah and Rahmat, \{Favian Ariiq\} and Ananda, \{Nadhif Faza\} and Taher, \{Mukhlis Akmal\} and Situmorang, \{Gerhard Reinaldi\} and Widi Atmoko and Nur Rasyid and Ponco Birowo",

note = "Publisher Copyright: {\textcopyright} 2026 The Authors",

year = "2026",

month = mar,

doi = "10.1016/j.eucr.2026.103366",

language = "English",

volume = "65",

journal = "Urology Case Reports",

issn = "2214-4420",

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Management of complex renal stones in horseshoe kidney using real-time intrarenal pressure monitoring with artificial intelligence in retrograde intrarenal surgery: A case report. / Achmadsyah, Armand; Rahmat, Favian Ariiq; Ananda, Nadhif Faza et al.
In: Urology Case Reports, Vol. 65, 103366, 03.2026.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Management of complex renal stones in horseshoe kidney using real-time intrarenal pressure monitoring with artificial intelligence in retrograde intrarenal surgery

T2 - A case report

AU - Achmadsyah, Armand

AU - Rahmat, Favian Ariiq

AU - Ananda, Nadhif Faza

AU - Taher, Mukhlis Akmal

AU - Situmorang, Gerhard Reinaldi

AU - Atmoko, Widi

AU - Rasyid, Nur

AU - Birowo, Ponco

PY - 2026/3

Y1 - 2026/3

N2 - Retrograde intrarenal surgery (RIRS) in horseshoe kidneys is technically challenging due to altered anatomy and unstable intrarenal pressure (IRP). We report a case of a 45-year-old male with complex renal stones in a horseshoe kidney managed using artificial intelligence (AI)-assisted real-time IRP monitoring during RIRS. The AI system dynamically regulated irrigation and suction to maintain IRP within a safe range (∼30 mmHg), improving intraoperative visibility and procedural control. Stone clearance was achieved without complications. This case highlights the feasibility and potential safety benefits of AI-assisted IRP monitoring in anatomically complex kidneys.

AB - Retrograde intrarenal surgery (RIRS) in horseshoe kidneys is technically challenging due to altered anatomy and unstable intrarenal pressure (IRP). We report a case of a 45-year-old male with complex renal stones in a horseshoe kidney managed using artificial intelligence (AI)-assisted real-time IRP monitoring during RIRS. The AI system dynamically regulated irrigation and suction to maintain IRP within a safe range (∼30 mmHg), improving intraoperative visibility and procedural control. Stone clearance was achieved without complications. This case highlights the feasibility and potential safety benefits of AI-assisted IRP monitoring in anatomically complex kidneys.

KW - Artificial intelligence

KW - Complex renal stones

KW - Horseshoe kidney

KW - Intrarenal pressure

KW - retrograde intrarenal surgery

UR - https://www.scopus.com/pages/publications/105029308282

U2 - 10.1016/j.eucr.2026.103366

DO - 10.1016/j.eucr.2026.103366

M3 - Article

AN - SCOPUS:105029308282

SN - 2214-4420

VL - 65

JO - Urology Case Reports

JF - Urology Case Reports

M1 - 103366

ER -

Management of complex renal stones in horseshoe kidney using real-time intrarenal pressure monitoring with artificial intelligence in retrograde intrarenal surgery: A case report

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Keywords

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