Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Urology Reports
Published in: Current Urology Reports 4/2015

01-04-2015 | New Imaging Techniques (A Rastinehad and S Rais-Bahrami, Section Editors)

Contemporary Assessment of Renal Stone Complexity Using Cross-Sectional Imaging

Authors: Piruz Motamedinia, Zhamshid Okhunov, Zeph Okeke, Arthur D. Smith

Published in: Current Urology Reports | Issue 4/2015

Login to get access

Abstract

Recently, several scoring systems have been proposed to predict outcomes of percutaneous nephrolithotomy, objectively and quantitatively assessing kidney calculi complexity using cross-sectional imaging. These scoring systems are promising new tools that can guide surgical decision making, predict surgical outcomes, counsel patients undergoing stone surgery, and improve standardized academic reporting in percutaneous kidney stone surgery. In this article, we review features of each of these systems, their similarities and differences, and their applicability in clinical practice and relevance in academic reporting.
Literature
1.••
Thomas K, Smith NC, Hegarty N, et al. The Guy's stone score—grading the complexity of percutaneous nephrolithotomy procedures. Urology. 2011;78:277. The Guy’s stone score combines the number of stones, their location, and abnormal patient anatomy into a score 1–4 to estimate stone-free rates following PCNL.CrossRefPubMed
2.
Mandal S, Goel A, Kathpalia R, et al. Prospective evaluation of complications using the modified Clavien grading system, and of success rates of percutaneous nephrolithotomy using Guy's Stone Score: a single-center experience. Indian J Urol. 2012;28:392.CrossRefPubMedCentralPubMed
3.
Ingimarsson JP, Dagrosa LM, Hyams ES, et al. External validation of a preoperative renal stone grading system: reproducibility and inter-rater concordance of the Guy's stone score using preoperative computed tomography and rigorous postoperative stone-free criteria. Urology. 2014;83:45.CrossRefPubMed
4.
Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182:844.CrossRefPubMed
5.••
Okhunov Z, Friedlander JI, George AK, et al. S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi. Urology. 2013;81:1154. The S.T.O.N.E. score uses the stone size, tract length, obstruction, number of calyces involved, and stone density from a patient’s preoperative CT scan to calculate complexity and estimate stone-free rates following PCNL.CrossRefPubMed
6.
Okhunov Z, Helmy M, Perez-Lansac A, et al. Interobserver reliability and reproducibility of S.T.O.N.E. nephrolithometry for renal calculi. J Endourol. 2013;27:1303.CrossRefPubMed
7.
Akhavein A, Henriksen C, Bird V. Prediction of single procedure success rate using STONE nephrolithometry surgical classification system with strict criteria for surgical outcome. J Urol. 2013;189:e627.CrossRef
8.••
Smith A, Averch TD, Shahrour K, et al. A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy. J Urol. 2013;190:149. The CROES nomogram is a continuous variable calculated by stone characteristics, patient data, and surgeon/center experience to estimate post-PCNL stone-free rates.CrossRefPubMed
9.•
Labadie, K., Okhunov, Z., Akhavein, A. et al. Evaluation and comparison of urolithiasis scoring systems in percutaneous kidney stone surgery. J Urol. 2014. In this head to head study, the relative performance of all the Guy’s, S.T.O.N.E., and CROES scores were compared and found to be equivocal in estimating stone-free rates. The Guy’s and S.T.O.N.E. scores were both predictive of blood loss and length of stay.
10.••
Mishra S, Sabnis RB, Desai M. Staghorn morphometry: a new tool for clinical classification and prediction model for percutaneous nephrolithotomy monotherapy. J Endourol. 2012;26:6. The authors calculate staghorn morphometry—a precise measurement of stone size and collecting system surgical complexity—using CT scan reconstruction imaging and third party 3D software.CrossRefPubMed
11.
Preminger GM, Assimos DG, Lingeman JE, et al. Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol. 2005;173:1991.CrossRefPubMed
12.••
Jeong CW, Jung JW, Cha WH, et al. Seoul National University Renal Stone Complexity Score for predicting stone-free rate after percutaneous nephrolithotomy. PLoS One. 2013;8:e65888. The S-ReSC is a simple yet elegant method of estimating stone-free rates following single-access PCNL by counting involved calyces.CrossRefPubMedCentralPubMed
13.
Choo MS, Jeong CW, Jung JH, et al. External validation and evaluation of reliability and validity of the S-ReSC scoring system to predict stone-free status after percutaneous nephrolithotomy. PLoS One. 2014;9:e83628.CrossRefPubMedCentralPubMed
14.
Tomaszewski JJ, Ortiz TD, Gayed BA, et al. Renal access by urologist or radiologist during percutaneous nephrolithotomy. J Endourol. 2010;24:1733.CrossRefPubMed
15.
Watterson JD, Soon S, Jana K. Access related complications during percutaneous nephrolithotomy: urology versus radiology at a single academic institution. J Urol. 2006;176:142.CrossRefPubMed
16.•
Resorlu B, Unsal A, Gulec H, et al. A new scoring system for predicting stone-free rate after retrograde intrarenal surgery: the “Resorlu-Unsal stone score”. Urology. 2012;80:512. The RUS score accounts for factors which pose as a challenge in flexible nephroscopy including the number and size of stones, and a narrow infundibulopelvic angle into a score predicting stone-free rates following ureteroscopy.CrossRefPubMed
17.•
Jung JW, Lee BK, Park YH, et al. Modified Seoul National University Renal Stone Complexity score for retrograde intrarenal surgery. Urolithiasis. 2014;42:335. The modified S-ReSC plays off of the original PCNL model which correlates increased calyceal involvement with decreased stone-free rates and adds additional complexity for lower pole stones.CrossRefPubMed
18.
Metadata
Title
Contemporary Assessment of Renal Stone Complexity Using Cross-Sectional Imaging
Authors
Piruz Motamedinia
Zhamshid Okhunov
Zeph Okeke
Arthur D. Smith
Publication date
01-04-2015
Publisher
Springer US
Published in
Current Urology Reports / Issue 4/2015
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-015-0494-x

Other articles of this Issue 4/2015

Current Urology Reports 4/2015 Go to the issue

Prostate Cancer (A Kibel, Section Editor)

Active Surveillance for Low-Risk Prostate Cancer

Men’s Health (R Carrion and C Yang, Section Editors)

Strategies for Penile Prosthesis Placement in Peyronie’s Disease and Corporal Fibrosis

Urothelial Cancer (A Sagalowsky, Section Editor)

Preoperative and Modifiable Factors to Lower Postoperative Complications After Radical Cystectomy

Urothelial Cancer (A Sagalowsky, Section Editor)

New Perioperative Fluid and Pharmacologic Management Protocol Results in Reduced Blood Loss, Faster Return of Bowel Function, and Overall Recovery

New Imaging Techniques (A Rastinehad and S Rais-Bahrami, Section Editors)

Preoperative Imaging for Staging Bladder Cancer

New Imaging Techniques (A Rastinehad and S Rais-Bahrami, Section Editors)

Post Partial Nephrectomy Surveillance Imaging: an Evidence-Based Approach