ArticleTherapeutic advances in urology
An innovative predictive scoring system for assessing stone-free rate of lower caliceal stones after flexible ureteroscopic lithotripsy: a retrospective cohort study.
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Abstract
Background: Lower caliceal stones (LCS) account for 25%-36% of all renal stones. Flexible ureteroscopic lithotripsy (FURL) is first-line treatment for LCS, but its stone-free rate (SFR) is significantly affected by renal anatomy and stone characteristics. Currently, there is a lack of specific, convenient scoring systems for predicting SFR of LCS after FURL. Objectives: To assess the factors influencing the SFR of LCS after FURL, and establish a practical, convenient, and accurate scoring system. Design: A single-center retrospective cohort study. Methods: A total of 149 patients who underwent FURL between September 2020 and December 2022 were divided into two groups based on the results of NCCT of the kidney performed 1 month after surgery: Group A (stone clearance group) with 112 patients and Group B (residual stone group) with 37 patients. Variables with Results: According to binary unconditional multivariate logistic regression analysis, stone length ( Conclusion: Stone length, stone CT value, renal pelvis shape, IPA, IW, and CPH were identified as independent factors influencing the SFR of LCS after FURL. Each factor was assigned a score of 1, resulting in a prediction scoring system with a total score of six points. A total score exceeding two was associated with a significantly reduced SFR. FURL was strongly recommended for scores of 0-1, used with caution for scores of 2-3, and not routinely recommended for scores 4-6.
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