scholarly journals External validation of the R.I.R.S. scoring system to predict stone-free rate after retrograde intrarenal surgery

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cong Wang ◽  
ShouTong Wang ◽  
Xuemei Wang ◽  
Jun Lu
Keyword(s):  
Scoring System ◽  
Kidney Stone ◽  
Medical Center ◽  
External Validation ◽  
Retrograde Intrarenal Surgery ◽  
Stone Burden ◽  
Stone Free Rate ◽  
Stone Density ◽  
Free Rate ◽  
Free Status

Abstract Background The R.I.R.S. scoring system is defined as a novel and straightforward scoring system that uses the main parameters (kidney stone density, inferior pole stones, stone burden, and renal infundibular length) to identify most appropriate patients for retrograde intrarenal surgery (RIRS). We strived to evaluate the accuracy of the R.I.R.S. scoring system in predicting the stone-free rate (SFR) after RIRS. Methods In our medical center, we retrospectively analyzed charts of patients who had, between September 2018 and December 2019, been treated by RIRS for kidney stones. A total of 147 patients were enrolled in the study. Parameters were measured for each of the four specified variables. Results Stone-free status was achieved in 105 patients (71.43%), and 42 patients had one or more residual fragments (28.57%). Differences in stone characteristics, including renal infundibulopelvic angle, renal infundibular length, lower pole stone, kidney stone density, and stone burden were statistically significant in patients whether RIRS achieved stone-free status or not (P < 0.001, P: 0.005, P < 0.001, P < 0.001, P: 0.003, respectively). R.I.R.S. scores were significantly lower in patients treated successfully with RIRS than patients in which RIRS failed (P < 0.001). Binary logistic regression analyses revealed that R.I.R.S. scores were independent factors affecting RIRS success (P = 0.033). The area under the curve of the R.I.R.S. scoring system was 0.737. Conclusions Our study retrospectively validates that the R.I.R.S. scoring system is associated with SFR after RIRS in the treatment of renal stones, and can predict accurately.

scholarly journals Outcomes of fluoroscopy-free retrograde intrarenal surgery and predictive factors of stone-free

2021 ◽  
Vol 93 (4) ◽  
pp. 425-430
Author(s):  
Huseyin Kocakgol ◽  
Hasan Riza Aydin ◽  
Ahmet Ozgur Guctas ◽  
Cagri Akin Sekerci ◽  
Deniz Ozturk Kocakgol ◽  
...  
Keyword(s):  
Operation Time ◽  
Female Gender ◽  
Ureteral Injury ◽  
Preoperative Imaging ◽  
Retrograde Intrarenal Surgery ◽  
Stone Size ◽  
Stone Burden ◽  
Stone Free Rate ◽  
Stone Density ◽  
Free Rate

Objective: To evaluate the outcomes of flouroscopy-free retrograde intrarenal surgery (ffRIRS) and to investigate the factors that may affect stone-free rate. Materials and methods: The charts of patients who underwent ffRIRS between January 2017 and August 2019 were reviewed retrospectively. Patients with missing preoperative imaging and patients with kidney anomalies were excluded from the study. Age, gender, stone size, stone localization, stone density, laterality, operation time, stone-free rate, complications and auxiliary procedures were recorded and analyzed. Results: Study group involved 44 (43.1%) female and 58 (56.8%) male patients. Stone-free rate in a single-session ffRIRS were found to be correlated with stone localization (p = 0.003), stone volume (p = 0.004), and stone density (p = 0.009) but not with age (p = 0.950). Patients with multiple calyceal stones and a stone burden over 520 mm3 were found to be less stone-free. The complication rate in female gender (n = 7) was significantly higher compared to male (n = 1) (p = 0.011). No major complications such as ureteral injury or avulsion were observed. Overall, 13 patients (12.7%) needed auxiliary procedures. The operation time seemed to be affected by stone size and gender (p = 0.005; p = 0.044, respectively). Conclusions: Stone-free rate in ffRIRS were found to be affected by stone density, size, and localization. Patients with multiple caliceal stones and high stone burden (< 520 mm3) have been found to have low stone-free rate, so one can speculate that having fluoroscopy assistance in RIRS might help us to improve surgical success.

scholarly journals Predictive factors of stone-free status in renal stone treatment with flexible ureterorenoscopy

2021 ◽  
Vol 42 (1) ◽  
pp. 21-26
Author(s):  
Suppasek Pattarawongpaiboon ◽  
◽  
Manint Usawachintachit ◽  
Keyword(s):  
Renal Stone ◽  
Univariate Analysis ◽  
Medium Size ◽  
P Value ◽  
Lower Pole ◽  
Flexible Ureterorenoscopy ◽  
Stone Burden ◽  
Stone Free Rate ◽  
Free Rate ◽  
Free Status

Objective: Flexible ureterorenoscopy (fURS) is one of the standard treatments for renal calculi up to 20 mm. This study aims to identify factors associated with stone-free status. Materials and Methods: We included patients undergoing fURS for treatment of small to medium-size renal stone (no single stone larger than 20 mm) from April 2017 to September 2019 at King Chulalongkorn Memorial Hospital. All patients had a preoperative CT scan and postoperative imaging for comparison. We collected patient characteristics (sex, age, previous ipsilateral urinary tract surgery, preoperative ureteral stent placement), stone factors (total stone burden, stone number, stone density) and renal factors (anatomical abnormalities, stone location in a lower pole, number of caliceal involvement) and correlated the data against postoperative stone-free status (defined as residual fragment ≤ 2 mm). Results: The overall stone-free rate was 53.3%. From the univariate analysis, previous surgery, total stone burden, stone number, stone location in the lower pole, and the number of caliceal involvement were associated with stone-free status. However, only the total stone burden remained statistically significant in the multivariate analysis (p-value < 0.05). The stone-free rates were 75.9%, 57.1%, and 11.1% in the total stone burden ≤ 10 mm, 11-20 mm, > 20 mm, respectively. Conclusion: Following treatment of renal stones ≤ 20 mm with fURS, the stone-free rate was 53.3% and was significantly associated with the preoperative total stone burden.

scholarly journals PERCUTANEOUS NEPHROLITOTOMY ON THE MANAGEMENT OF CALYX INFERIOR STONES

2014 ◽  
Vol 21 (2) ◽  
Author(s):  
Pande Made Wisnu Tirtayasa ◽  
Ponco Birowo ◽  
Nur Rasyid
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Medical Records ◽  
Renal Ultrasonography ◽  
Abdominal Radiography ◽  
Stone Burden ◽  
Stone Free Rate ◽  
Plain Abdominal Radiography ◽  
Free Rate ◽  
Free Status ◽  
Residual Fragments

Objectives: To compare the stone free rates of inferior calyceal stones with stone burden < 20 mm, 21-30 mm, and > 30 mm on post-percutaneous nephrolithotomy (PCNL) patients in Cipto Mangunkusumo Hospital. Material & method: The data was collected retrospectively from PCNL medical records in Cipto Mangunkusumo Hospital between January 2000 until May 2012. Patients were followed-up with plain abdominal radiography (BNO) or renal ultrasonography (USG). Stone free status was defined as no residual fragments on radiography or USG. Results: As many as 88 patients with inferior calyceal stones who underwent PCNL were included. Forty-three cases had stone burden < 20 mm, 34 cases with stone burden 21-30 mm, and 11 cases with stone burden > 30 mm. Overall, 81 (92%) cases were defined as stone free. On group < 20 mm, 21-30 mm, and > 30 mm; 41 (95%), 32 (94%), and 8 (73%) cases defined as stone free respectively (p = 0.485). Conclusion: PCNL is the primary modalityon the management of calyx inferior stones with high stone free rate. The stone free rate of these three groups showed no statistically significant difference.Keywords: Percutaneous nephrolithotomy, inferior calyx stone, stone free rate.

scholarly journals Factors related to the success rate of pediatric extracorporeal shock wave lithotripsy (ESWL) in Cipto Mangunkusumo Hospital: an 8-year single-center experience

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Adistra Imam Satjakoesoemah ◽  
Fekhaza Alfarissi ◽  
Irfan Wahyudi ◽  
Arry Rodjani ◽  
Nur Rasyid
Keyword(s):  
Shock Wave ◽  
Success Rate ◽  
Shock Wave Lithotripsy ◽  
Urinary Stone ◽  
Factors Associated ◽  
Stone Burden ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Free Rate ◽  
Free Status

Abstract Background ESWL is still considered as the first favorable therapeutic option for urinary stone disease with acceptable effectivity. However, factors associated with favorable outcome have not been widely studied in pediatrics due to the small number of urinary stone prevalence. The aim of this study is to evaluate the factors associated with the success rate of pediatric ESWL in our center according to immediate stone-free rate and 3-month stone-free rates. Methods This is a retrospective cohort study of children less than 18 years who had ESWL for urolithiasis from January 2008 until August 2015. Patient’s characteristics including age, gender, BMI, stone location, stone length, stone burden, stone opacity, and number of ESWL sessions were gathered from the medical record. Nutritional status was determined according to the Centers for Disease Control and Prevention BMI curve. The outcome of this study was the factors related to the success rate in pediatric ESWL. Results Extracorporeal shock wave lithotripsy was done for 36 patients and 39 renal units (RUs) with mean age of 13.7 ± 4.3 years old, height of 1480 ± 16.0 cm, and BMI of 20.0 ± 3. Of 36 patients included, 39 renoureteral units (RUs) and 46 ESWL sessions were recorded. The mean overall treatment was 1.2 ± 0.5 sessions with mean stone length of 11.1 ± 6.3 mm and stone burden of 116.6 ± 130.3 mm2. Within 3 months of follow-up, we recorded that the overall 3-month success rate was 100%, while the overall 3-month stone-free rate was 66.7%. Stone length (p < 0.001 and p < 0.001), stone perpendicular length (p < 0.001 and p < 0.001), and stone burden (p < 0.001 and p = 0.001) were found to be significantly associated with immediate success and 3-month stone-free status, respectively. Conclusions ESWL is an effective and safe modality to treat pediatric urolithiasis cases. Stone length, stone perpendicular length, and stone burden were found to be associated with immediate success and 3-month stone-free status after pediatric ESWL treatment.

scholarly journals The R.I.R.S. scoring system: An innovative scoring system for predicting stone-free rate following retrograde intrarenal surgery

BMC Urology ◽  
2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Yinglong Xiao ◽  
Deng Li ◽  
Lei Chen ◽  
Yaoting Xu ◽  
Dingguo Zhang ◽  
...  
Keyword(s):  
Scoring System ◽  
Retrograde Intrarenal Surgery ◽  
Stone Free Rate ◽  
Free Rate

Evaluation of various nephrometric scoring system for nephrolithiasis to predict stone free status after percutaneous nephrolithotomy: A comparative study

2021 ◽  
pp. 039156032110301
Author(s):  
Souvik Chatterjee ◽  
Anand Abhishek ◽  
Kaniska Samanta ◽  
Anupama Ghosh ◽  
Soumendra Nath Mandal ◽  
...  
Keyword(s):  
Scoring System ◽  
Perioperative Complications ◽  
Scoring Systems ◽  
Roc Curves ◽  
P Value ◽  
Limited Data ◽  
Exclusion Criteria ◽  
Stone Free Rate ◽  
Free Rate ◽  
Free Status

Background: The CROES Nephrolithometry nomogram, S.T.O.N.E. Nephrolithometry Score and Guy’s stone score were introduced for stratification of kidney stones disease on the basis of quantitative stone burden and its distribution. Till date there has been very limited data on head to head comparison of the existing scoring systems. Comparison and analyses among the scoring system helps in further refinement of these systems along with development of new more effective and broadly acceptable nomogram. Objective: Predictability of the stone-free status (SFS) and post-operative complication after PCNL by various scoring systems (The CROES nomogram, S.T.O.N.E. nephrolithometry score and Guy’s stone score). Materials and Methods: Total 100 adult patients underwent PCNL after considering inclusion and exclusion criteria. All patients underwent Preoperative NCCT scan, investigations of blood (Hb%, PCV, bleeding and coagulation profile, urea, and creatinine), and urine (RE/ME and C/S), Postoperative X ray KUB/NCCT. Results: ROC curves were developed for each scoring system to determine the accuracy to predict stone free status. We found CS had significantly higher AUC than other scoring systems [ p-value for CS vs GSS = 0.0091 & CS vs SS = 0.000]. So CS has higher accuracy to predict stone free status. None of the scoring system had shown significantly higher AUC than other scoring system in predicting complication. Conclusion: CROES Nephrolithometry nomogram is most accurate to predict preoperative stone-free rate. All scoring systems can equally predict perioperative complications and other variables.

Flexible Ureteroscopy with Holmium Laser Lithotripsy: A New Choice for Intrarenal Stone Patients

2014 ◽  
Vol 94 (1) ◽  
pp. 93-98 ◽  
Author(s):  
Chen Xu ◽  
Ri-jin Song ◽  
Min-jun Jiang ◽  
Chao Qin ◽  
Xiao-lan Wang ◽  
...  
Keyword(s):  
Renal Stones ◽  
Laser Lithotripsy ◽  
Flexible Ureteroscopy ◽  
Stone Fragment ◽  
Stone Burden ◽  
Holmium Laser Lithotripsy ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Free Rate ◽  
Free Status

Objective: To evaluate the efficiency and safety of flexible ureteroscopy (FURS) and holmium lithotripsy for intrarenal stones and to stratify the efficiency and safety by stone burdens of ≤20, 20-40, and ≥40 mm. Methods: Five hundred eighty-two patients with intrarenal stones were treated with FURS and holmium lithotripsy at a single department from August 2008 to October 2013. Stone size was evaluated by calculating the cumulative stone diameter of all intrarenal stones, and stone-free status was defined as the absence of any stone or stone fragment <1 mm in the kidney. Results: Data analysis revealed a mean stone burden of 21.8 ± 7.6 mm. The overall primary stone-free rate (SFR) was 65.3%, which increased to 89.0% 6 months after the first surgery. Complications developed in 6.7% of patients. A significant difference was found between lower-calyx stones and other stones (p < 0.001; p = 0.006), while noncalcium stones had a much higher SFR than calcium stones (p < 0.001; p = 0.04). Conclusion: Our study showed that the overall renal SFR with the use of FURS and holmium lithotripsy was satisfactory, with a relatively low complication rate. We believe that FURS with holmium lithotripsy could be a valuable choice for patients with renal stones, especially for patients with a cumulative stone burden ≤40 mm.

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