Objective: To investigate free-stone rate after Percutaneous Nephrolithotomy (PNL) using S.T.O.N.E nephrolitometry scoring system, with regards of stone size (S), skin-to-stone distance (T), obstruction degree (O), number of calyx involved (N), and stone density (E) in Non Contrast CT Scan (NCCT). Material & methods: This is an analytic observational study on patients with renal stones undergoing PNL. All patients underwent NCCT before and after PNL; each variables was measured and counted for a total score. Post-operative evaluation was done using NCCT. Results: Thirty patients met inclusion criteria, 19 (63.3%) were stone-free, and 11 (36.7%) were with residual stone. Among the five variables, stone size (p=0.005), number of calyx involved (p=0.002) affected the outcome of surgery, while skin-to-stone distance, obstruction degree, and stone density did not. The overall total score of S.T.O.N.E nephrolithometry is correlated with the outcome of PNL (p=0.001). Conclusion: S.T.O.N.E nephrolithometry is a simple scoring system, while it is also easy to use, and can be used to predict the free-stone rate after PNL.
Percutaneous nephrolithotomy, scoring system, renal stone, non contrast CT Scan
Stoller ML. Urinary stone disease. In: Tanagho EA, McAninch JW, Smith MD, Donald R, editors. Smith’s General Urology, 17th ed. New York: McGrawhill. 2008; 16: 247-57.
Wibisono DS, Tarmono, Soebadi MD. Percutaneous nephrolithotomy procedures profile in Dr. Soetomo General Hospital from January 2007 - Juny 2010. Jurnal Urologi Universitas Airlangga, Surabaya. 2013; 1(2): 12.
Pearle MS, Lotan Y. Urinary lithiasis and endourology: Surgical management of upper urinary tract calculi. In: Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Chambell-Walsh Urology, 10th ed. Phildelphia: Elsevier. 2012; 1: 1400-7.
Noureldin Y, Elkoushy M, Andonian S. Which is better? Guy’s versus S.T.O.N.E nephrolithometry scoring systems in predicting stone-fre status post percutaneous nephrolithotomy. World J Urol; 2015.
Labadie K, Okhunov Z, Akhavein A, Moreira DM, Moreno-Palacios J, del Junko M. Evaluation and comparison of urolithiasis scoring system used in percutaneous kidney stone surgery. J Urol. 2015; 193: 154-9.
Okhunov Z, Friedlander JI, George AK. S.T.O.N.E nephrolitometry: Novel surgical classification system for kidney calculi. J Urol. 2012; 81(6): 1154-60.
Farhan M, Nazim SM, Salam B, Ather MH. Prospective evaluation of outcome of percutaneous nephrolithotomy using the S.T.O.N.E nephrolithometry score: A single centre experience. Arab J Urol. 2015; 13: 264-9.
Smith A, Averch TD, Shahrour K, Opondo D, Daels FPJ, Labate G, et al. A nephrolitometric nomogram to predict treatment success of percutaneous nephrolithotomy. J Urol. 2013; 190: 149-56.
Ortiz T, Martinez M, Morton V, Reyes V, Feixas C, Novo S, et al. Obesity in percutaneous nephrolithotomy. Is body mass index really important? J Urol. Sept 2014; 84(3): 538-43.
Simsek A, Ozgor F, Akbulut MF, Onur K, Yalcin A, Sarilar O, et al. Does body mass index effect the success of percutaneous nephrolithotomy? Turk J Urol. Jun 2014; 40(2): 104-9.
Alyami FA, Skinner TA, Norman RW. Impact of body mass index on clinical outcomes associated with percutaneous nephrolithotomy. Can Urol Assoc J. Mar-Apr 2013; 7(3-4): E197-201.
Zhu Z, Wang S, Xi Q, Bai J, Yu X, Liu J, et al. Logistic regression model for predicting stone-free rate after minimally invasive percutaneous nephrolithotomy. J Urol. 2011; 78: 32-36.