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ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 1  |  Page : 14-18

Reliability and validity of “S.T.O.N.E” nephrolithometry scoring system to predict the stone-free rate after percutaneous nephrolithotomy


1 Department of Urology, Al-Azhar University Hospitals, Cairo, Egypt
2 Department of Diagnostic Radiology, Al-Azhar University Hospitals, Cairo, Egypt

Correspondence Address:
Dr. Abdrabuh Mostafa Ibrahim Abdrabuh
Department of Urology, Al-Azhar University Hospitals, Cairo
Egypt
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DOI: 10.4103/UA.UA_158_19

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Objective: The objective was to assess the reliability and validity of“S.T.O.N.E” nephrolithometry scoring system to predict the stone-free rate (SFR) after percutaneous nephrolithotomy (PNL). Methods: A total of 123 patients with unilateral radiopaque stones ≥2 cm were included in the study. According to S.T.O.N.E score, five parameters available from preoperative computed tomography (CT) without contrast were measured: stone size (S), tract length (T), obstruction (O), number of involved calices (N), and essence of stone (E). The Stone free rates evaluated within one month postoperatively by plain X-ray and/or CT scan without contrast. Results: The mean S.T.O.N.E. score in this study was 7.4 in stone-free (SF) group and 9.3 in residual stone group (P = 0.0001). Patients with SF comprised 82.1% after the first PNL, whereas 17.9% had significant residual stones >4 mm. Postoperative complications were 8%. The most common complications were bleeding requiring transfusion. The size of stone (P = 0.002) and number of calices involved (P = 0.001) had a statistically significant difference between patients with residual stones, other components were not. There was a statistically significant difference between non-SF and SF according to the hospital stay (P = 0.002). Conclusion: This score predicted the clearance after PNL. The size of calculi and number of calices involved statistically affected the stone clearance, whereas other S.T.O.N.E scoring parameters were not. There was a statistically significant difference between SF and residual stones groups according to the hospital stay (P = 0.0001).


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