https://doi.org/10.4081/aiua.2022.3.311

External validation of Resorlu-Unsal stone score in predicting outcomes after retrograde intrarenal surgery. Experience from a single institution

Vol. 94 No. 3 (2022)
Published: September 26, 2022
Stone; Kidney; Endoscopic; RIRS; Stone free rate.
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Authors

Antonio Tufano
antonio.tufano91@gmail.com
Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy.
Marco Frisenda
Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy.
Antonio Rossi
“Cristo Re” Hospital, Rome, Italy.
Pietro Viscuso
Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy.
Guglielmo Mantica
Policlinico San Martino, Genova, Italy.
Pierluigi Bove
San Carlo di Nancy Hospital, Roma, Italy.
Rosario Leonardi
Casa di Cura Musumeci- Gecas, Gravina di Catania (CT), Italy.
Alessandro Calarco
“Cristo Re” Hospital, Rome, Italy.

Objective: Pre-operative assessment of renal stones is essential in selecting treatment options and achieving high success rates for retrograde intrarenal surgery (RIRS). Several nephrolithometric scoring systems have been developed using pre-operative clinical data and stone characteristics. Resorlu-Unsal stone score (RUSS) is composed of four different parameters, and each of them adds 1 point to the final score. One point is added in patients with stone size > 20 mm, lower calyceal stones and infundibulo-pelvic angle < 45°, stone number > 1, and abnormal anatomy, respec-tively. RUSS categorizes patients into four distinct groups and aims to predict stone-free rates (SFR) after RIRS. We externally validated RUSS and evaluated its predictive accuracy.
Materials and Methods: We performed a retrospective analysis of patients who underwent RIRS for renal stones between January 2020 and December 2021. Patient age, pre-operative hydronephrosis, stone size, stone density as Hounsfield Unit
(HU), operative time and RUSS were investigated as potential preoperative predictive factors for stone-free status. RUSS was applied to all patients, and the nomogram was externally vali-dated. Area under the curve (AUC) was used for clinical validity assessment.
Results: The present study included a total of 79 patients. Mean patient age was 55.1 ± 15.4 years with a mean stone size was 14.2 ± 4.4 mm. Overall, 62/79 (78.4%) patients were stone free after the initial treatment. After applying RUSS, 36 (45.6%), 29 (36.7%), 10 (12.6%), and 4 (5.1%) patients had a score of 0, 1, 2, and 3, respectively. On multivariate logistic regression RUSS (OR = 0.220; 95%CI: 0.086-0.567; p = 0.002) was identified as the only predictor of postoperative stone-free status.
Conclusions: RUSS is a user-friendly scoring system that may predict postoperative stone-free rate after RIRS with great effi-cacy and accuracy.

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How to Cite

Tufano, A., Frisenda, M., Rossi, A., Viscuso, P., Mantica, G., Bove, P., Leonardi, R., & Calarco, A. (2022). External validation of Resorlu-Unsal stone score in predicting outcomes after retrograde intrarenal surgery. Experience from a single institution. Archivio Italiano Di Urologia E Andrologia, 94(3), 311–314. https://doi.org/10.4081/aiua.2022.3.311

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