Preoperative Prediction of Flexible Ureteroscopy Outcome in the Treatment of Renal Calculi
Study Details
Study Description
Brief Summary
To predict the outcome of flexible ureteroscopy in the management of renal stones based on preoperative scoring module using five preoperative parameters that have effect on stone free status postoperatively.
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Detailed Description
Although flexible ureteroscopy has been in use for decades, neither the European Association of Urology (EAU) nor the American Urological association (AUA), in their clinical guidelines, recommends flexible ureteroscopy (FURS) as a first-line procedural treatment for renal stones . Several reports showed that FURS is a suitable alternative to shockwave lithotripsy (SWL) and percutaneous nephrolithotripsy (PCNL) for the treatment of renal stones, with potentially higher stone-free rates than SWL and lower morbidity than PCNL.
Safe and effective removal by FURS of multiple and large intrarenal stones, including lower pole calculi, has been documented suggesting that FURS is effective for complex intrarenal stone removal . With the multitude of available procedures, selection of the optimal one for management of renal stone is becoming more challenging.
Established models for predicting the outcomes of SWL and PCNL exist . However, a predictive model for predicting the outcome of URS is still in development , particularly for FURS treatment of renal stones. Four scores have been developed for FURS. Two of these have been compared and validated in different cohorts: the Resolu Unsal Stone Score (RUSS) and modified Seoul National University Renal Stone Complexity (S-ReSC) score , the other two scores, the S.T.O.N.E score described by Molina et al. and Ito's nomogram.
Many studies have demonstrated that stone volume is the most significant factor predictive of stone-free status (SF) after FURS. The investigators speculate that stone volume combined with other variables might improve prediction of SF after FURS. The aim of the present study is to evaluate various preoperative parameters as predictors of FURS outcome based on the Ito's nomogram
Study Design
Outcome Measures
Primary Outcome Measures
- stone free rate after flexible ureteroscopy [baseline]
the investigators predict the outcome of flexible ureteroscopy in the management of renal stones based on preoperative scoring module using five preoperative parameters that have effect on stone free rate postoperatively.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Renal stones (≤ 2 cm)
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Radiolucent stone resistant to SWL and oral chemical dissolution treatment (≤2cm)
Exclusion Criteria:
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Large stones (> 2 cm).
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Staghorn stone (stone involving the renal pelvis and more than two calyces).
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Patient preference of other treatment modality
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Menoufia University
Investigators
- Principal Investigator: Mohamed Abdelgaber Selim, ASS-PROF, menofia universtiy
Study Documents (Full-Text)
None provided.More Information
Publications
- Akman T, Binbay M, Ozgor F, Ugurlu M, Tekinarslan E, Kezer C, Aslan R, Muslumanoglu AY. Comparison of percutaneous nephrolithotomy and retrograde flexible nephrolithotripsy for the management of 2-4 cm stones: a matched-pair analysis. BJU Int. 2012 May;109(9):1384-9. doi: 10.1111/j.1464-410X.2011.10691.x. Epub 2011 Oct 28.
- Breda A, Ogunyemi O, Leppert JT, Lam JS, Schulam PG. Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater--is this the new frontier? J Urol. 2008 Mar;179(3):981-4. doi: 10.1016/j.juro.2007.10.083. Epub 2008 Jan 22.
- Breda A, Ogunyemi O, Leppert JT, Schulam PG. Flexible ureteroscopy and laser lithotripsy for multiple unilateral intrarenal stones. Eur Urol. 2009 May;55(5):1190-6. doi: 10.1016/j.eururo.2008.06.019. Epub 2008 Jun 13.
- Cohen J, Cohen S, Grasso M. Ureteropyeloscopic treatment of large, complex intrarenal and proximal ureteral calculi. BJU Int. 2013 Mar;111(3 Pt B):E127-31. doi: 10.1111/j.1464-410X.2012.11352.x. Epub 2012 Jul 3.
- El-Nahas AR, Ibrahim HM, Youssef RF, Sheir KZ. Flexible ureterorenoscopy versus extracorporeal shock wave lithotripsy for treatment of lower pole stones of 10-20 mm. BJU Int. 2012 Sep;110(6):898-902. doi: 10.1111/j.1464-410X.2012.10961.x. Epub 2012 Feb 28.
- Imamura Y, Kawamura K, Sazuka T, Sakamoto S, Imamoto T, Nihei N, Suzuki H, Okano T, Nozumi K, Ichikawa T. Development of a nomogram for predicting the stone-free rate after transurethral ureterolithotripsy using semi-rigid ureteroscope. Int J Urol. 2013 Jun;20(6):616-21. doi: 10.1111/j.1442-2042.2012.03229.x. Epub 2012 Nov 19.
- Ito H, Kawahara T, Terao H, Ogawa T, Yao M, Kubota Y, Matsuzaki J. The most reliable preoperative assessment of renal stone burden as a predictor of stone-free status after flexible ureteroscopy with holmium laser lithotripsy: a single-center experience. Urology. 2012 Sep;80(3):524-8. doi: 10.1016/j.urology.2012.04.001. Epub 2012 Jun 1.
- Ito H, Kawahara T, Terao H, Ogawa T, Yao M, Kubota Y, Matsuzaki J. Utility and limitation of cumulative stone diameter in predicting urinary stone burden at flexible ureteroscopy with holmium laser lithotripsy: a single-center experience. PLoS One. 2013 Jun 4;8(6):e65060. doi: 10.1371/journal.pone.0065060. Print 2013.
- Ito H, Sakamaki K, Kawahara T, Terao H, Yasuda K, Kuroda S, Yao M, Kubota Y, Matsuzaki J. Development and internal validation of a nomogram for predicting stone-free status after flexible ureteroscopy for renal stones. BJU Int. 2015 Mar;115(3):446-51. doi: 10.1111/bju.12775. Epub 2014 Aug 13.
- 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 Aug;42(4):335-40. doi: 10.1007/s00240-014-0650-7. Epub 2014 Mar 13.
- Kanao K, Nakashima J, Nakagawa K, Asakura H, Miyajima A, Oya M, Ohigashi T, Murai M. Preoperative nomograms for predicting stone-free rate after extracorporeal shock wave lithotripsy. J Urol. 2006 Oct;176(4 Pt 1):1453-6; discussion 1456-7. doi: 10.1016/j.juro.2006.06.089.
- Molina WR, Kim FJ, Spendlove J, Pompeo AS, Sillau S, Sehrt DE. The S.T.O.N.E. Score: a new assessment tool to predict stone free rates in ureteroscopy from pre-operative radiological features. Int Braz J Urol. 2014 Jan-Feb;40(1):23-9. doi: 10.1590/S1677-5538.IBJU.2014.01.04.
- Pearle MS, Lingeman JE, Leveillee R, Kuo R, Preminger GM, Nadler RB, Macaluso J, Monga M, Kumar U, Dushinski J, Albala DM, Wolf JS Jr, Assimos D, Fabrizio M, Munch LC, Nakada SY, Auge B, Honey J, Ogan K, Pattaras J, McDougall EM, Averch TD, Turk T, Pietrow P, Watkins S. Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less. J Urol. 2008 May;179(5 Suppl):S69-73. doi: 10.1016/j.juro.2008.03.140.
- Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck C, Gallucci M, Knoll T, Lingeman JE, Nakada SY, Pearle MS, Sarica K, Turk C, Wolf JS Jr; EAU/AUA Nephrolithiasis Guideline Panel. 2007 guideline for the management of ureteral calculi. J Urol. 2007 Dec;178(6):2418-34. doi: 10.1016/j.juro.2007.09.107. No abstract available.
- 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 Sep;80(3):512-8. doi: 10.1016/j.urology.2012.02.072. Epub 2012 Jul 26.
- Smith A, Averch TD, Shahrour K, Opondo D, Daels FP, Labate G, Turna B, de la Rosette JJ; CROES PCNL Study Group. A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy. J Urol. 2013 Jul;190(1):149-56. doi: 10.1016/j.juro.2013.01.047. Epub 2013 Jan 23.
- Takazawa R, Kitayama S, Tsujii T. Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater. Int J Urol. 2012 Mar;19(3):264-7. doi: 10.1111/j.1442-2042.2011.02931.x. Epub 2011 Dec 6.
- Tiselius HG, Ackermann D, Alken P, Buck C, Conort P, Gallucci M; Working Party on Lithiasis, European Association of Urology. Guidelines on urolithiasis. Eur Urol. 2001 Oct;40(4):362-71. doi: 10.1159/000049803.
- Wiesenthal JD, Ghiculete D, Ray AA, Honey RJ, Pace KT. A clinical nomogram to predict the successful shock wave lithotripsy of renal and ureteral calculi. J Urol. 2011 Aug;186(2):556-62. doi: 10.1016/j.juro.2011.03.109.
- FURS outcome prediciton