Presented by: Chinnakhet Ketsuwan
Faculty of Medicine Ramathibodi Hospital, Mahidol University

Introduction

The modified Seoul National University Renal Stone Complexity scoring system (S-ReSC-R) has been proposed as a novel prediction tool for urolithiasis management, including retrograde intrarenal surgery and percutaneous nephrolithotomy. We aim to determine the S-ReSC-R score system for application in extracorporeal shock wave lithotripsy (ESWL) in predicting stone-free rates.

Materials

The data of patients who received ESWL between 2018 and 2020 at a tertiary referral center were audited retrospectively. A total of 200 patients were included, and an S-ReSC-R score was assigned according to the number of sites involved in the collecting system. The stone-free rate (SFR) was examined. We applied receiver operating characteristic curve analysis to the data to evaluate the predictive accuracy.

Results

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The overall SFR after single-session treatment was 61.5%. The S-ReSC-R scores were significantly higher in patients successfully treated with ESWL compared with patients in whom ESWL failed (p < 0.001). SFR was significantly decreased in the order of low (1–2: 70.1%), intermediate (3–4: 38.2%), and high (5–12: 20.0%) score groups, respectively (p < 0.001). The multivariate analyses demonstrated that a S-ReSC-R score was identified as independent factors affecting SWL success (p = 0.021). The area under the receiver operating characteristic curve of the S-ReSC-R score was 0.742.

Conclusion

The S-ReSC-R was proven to be an effective tool for predicting SFR following ESWL. Therefore, patients who plan to undergo ESWL should be evaluated with S-ReSC-R before surgery.

Funding

No funding.

Lead Authors

Yada Phengsalae,
Faculty of Medicine Ramathibodi Hospital, Mahidol University

Premsant Sangkum,
Division of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital

Wisoot Kongchareonsombat,
Faculty of Medicine Ramathibodi Hospital, Mahidol University

Tipatai Yodplob,
Ranong Hospital