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

Authors

  • Suppasek Pattarawongpaiboon Division of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
  • Manint Usawachintachit Division of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand

DOI:

https://doi.org/10.52786/isu.a.18

Keywords:

Flexible ureterorenoscopy, stone-free status, renal stone

Abstract

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.

References

Gridley CM, Knudsen BE. Digital ureteroscopes: technology update. Res Rep Urol 2017; 9:19-25.

Cho SY. Current status of flexible ureteroscopy in urology. Korean J Urol 2015;56:680-8.

Marshall VF. Fiber optics in urology. J Urol 1964;91:110-4.

Bagley DH, Huffman JL, Lyon ES. Flexible ureteropyeloscopy: diagnosis and treatment in the upper urinary tract. J Urol 1987;138:280-5.

Turk C, Petrik A, Sarica K, Seitz C, Skorarikos A, Straub M, et al. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol 2016;69:475- 82.

Brian R. Matlaga, Amy E. Krambeck, James E. Lingeman. Surgical management of Upper Urinary Tract Calculi. In: Alan J. Wein, Louis R. Kavoussi, Alan W. Partin, Craig A. Peter, editors. Campbell-Walsh Urology. 11th ed. Philadelphia: Elsevier; 2016. p. 1260-90.

Resorlu B, Unsal A, Gulec H, Oztuna D. A new scoring system for predicting stone-free rate after retrograde intrarenal surgery: the “resorlu-unsal stone score”. Urology 2012;80:512-8.

Jung JW, Lee BK, Park YH, Lee S, Jeong SJ, Lee SE, Jeong CW. Modified Seoul National University renal stone complexity score for retrograde intrarenal surgery. Urolithiasis 2014;42:335-40.

Xiao Y, Li D, Chen L, Xu Y, Zhang D, Shao Y, Lu J. The R.I.R.S. scoring system: An innovative scoring system for predicting stone-free rate following retrograde intrarenal surgery. BMC Urol 2017;17:105.

Tonyalı Ş, Yılmaz M, Karaaslan M, Ceylan C, Işıkay L. Prediction of stone-free status after single-session retrograde intrarenal surgery for renal stones. Turk J Urol 2018;44:473-7.

Assimos D, Krambeck A, Miller NL, Monga M, Murad MH, Nelson CP, et al. Surgical Management of stones: American Urological Association/Endourological Society Guideline, PART II. J Urol 2016; 196:1161-9.

Additional Files

Published

2021-06-01

How to Cite

Pattarawongpaiboon, S., & Usawachintachit, M. (2021). Predictive factors of stone-free status in renal stone treatment with flexible ureterorenoscopy. Insight Urology, 42(1), 21–26. https://doi.org/10.52786/isu.a.18

Issue

Section

Original article