Abstract
BackgroundTo establish and internally validate an innovative R.I.R.S. scoring system that allows urologists to preoperatively estimate the stone-free rate (SFR) after retrograde intrarenal surgery (RIRS).MethodsThis study included 382 eligible samples from a total 573 patients who underwent RIRS from January 2014 to December 2016. Four reproducible factors in the R.I.R.S. scoring system, including renal stone density, inferior pole stone, renal infundibular length and stone burden, were measured based on preoperative computed tomography of urography to evaluate the possibility of stone clearance after RIRS.ResultsThe median cumulative diameter of the stones was 14 mm, and the interquartile range was 10 to 21. The SFR on postoperative day 1 in the present cohort was 61.5% (235 of 382), and the final SFR after 1 month was 73.6% (281 of 382). We established an innovative scoring system to evaluate SFR after RIRS using four preoperative characteristics. The range of the R.I.R.S. scoring system was 4 to 10. The overall score showed a great significance of stone-free status (p < 0.001). The area under the receiver operating characteristic curve of the R.I.R.S. scoring system was 0.904.ConclusionsThe R.I.R.S. scoring system is associated with SFR after RIRS. This innovative scoring system can preoperatively assess treatment success after intrarenal surgery and can be used for preoperative surgical arrangement and comparisons of outcomes among different centers and within a center over time.
Highlights
To establish and internally validate an innovative R.I.R.S. scoring system that allows urologists to preoperatively estimate the stone-free rate (SFR) after retrograde intrarenal surgery (RIRS)
Urolithiasis is one of the most common diseases in urology. It has a prevalence rate of 5.8% in China, of which the most common form is kidney stones [1]. Treatments such as extracorporeal shock wave lithotripsy (SWL), ureteroscopic lithotripsy, retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PNL) are first-line interventional therapies for urolithiasis according to the European Association of Urology (EAU) guidelines [2]
As a string of scoring systems have been established for evaluating stone-free rate (SFR) and complications, PNL can be more predicted than ever before; [5] yet few criteria remain to preoperatively assess the SFR after RIRS due to a relatively short period of popularization as a first-line treatment for renal stones based on guidelines of the EAU
Summary
To establish and internally validate an innovative R.I.R.S. scoring system that allows urologists to preoperatively estimate the stone-free rate (SFR) after retrograde intrarenal surgery (RIRS). It has a prevalence rate of 5.8% in China, of which the most common form is kidney stones [1] Treatments such as extracorporeal shock wave lithotripsy (SWL), ureteroscopic lithotripsy, retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PNL) are first-line interventional therapies for urolithiasis according to the European Association of Urology (EAU) guidelines [2]. As a string of scoring systems have been established for evaluating stone-free rate (SFR) and complications, PNL can be more predicted than ever before; [5] yet few criteria remain to preoperatively assess the SFR after RIRS due to a relatively short period of popularization as a first-line treatment for renal stones based on guidelines of the EAU. The primary aim was to develop an innovative scoring system and to
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