Procedural factors outweigh anatomical morphometry in predicting postoperative pain following retrograde intrarenal surgery

Modifiable procedural factors-intrarenal pressure, complications, and laser energy-are the main determinants of postoperative pain following RIRS in patients with normal anatomy, while anatomical measurements lack predictive value. Optimizing intraoperative practices offers greater clinical benefit than preoperative morphometric assessment. These findings support deprioritizing resource-intensive anatomical profiling for pain prediction in RIRS. Preoperative anatomical profiling should not be routinely performed for pain prediction, as procedural optimization represents modifiable targets with greater impact on patient outcomes.