External validation of the T.O.HO. score and derivation of the modified T.O.HO. score for predicting stone-free status after flexible ureteroscopy in ureteral and renal stones

Polat, Salih; Danacıoğlu, Yavuz Onur; Soytaş, Mustafa; Yarımoğlu, Serkan; Koraş, Ömer; Fakir, Ali Emre; Şeker, Kamil Gökhan; Değirmenci, Tansu

doi:10.22541/au.162260357.73633474/v1

Cited by 3 publications

(4 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, taking the length into consideration, the quasi-circular stones had a bigger stones volume. The larger the stone burden was, the lower the SFR was (8). There were three ureteroscopic procedures in this study.…”

Section: Discussionmentioning

confidence: 92%

A simple predictive model with internal validation for assessment of stone-left after ureteroscopic lithotripsy in upper ureteral stones

Zhang

et al. 2022

Transl Androl Urol

View full text Add to dashboard Cite

Background: Stone free rate in upper ureteral stones is not as high. We sought to identify easily accessible risk factors attributing to stones left in the ureteroscopy in the treatment of upper ureteral calculi, and to build a simple and reliable predictive model. Methods:Patients treating only for upper ureteral stones in 2018 were retrospectively analyzed.Correlations between factors and the stone free rate were analyzed using bidirectional stepwise regression, curve fitting and binary logistic regression. Stone shape was judged by the gap between length and width in the two-dimensional section. A predictive nomogram model was built based on those selected variables (P<0.05). The area under the receiver operator characteristic curve (AUC) and calibration curve were used to access its discrimination and calibration. Decision curve analysis (DCA) was conducted to test the clinical usefulness.Results: Totally, 275 patients with 284 stones were enrolled in this research. Bidirectional stepwise regression showed that stone length had a significant effect on stone free, instead of width or burden. Stone shapes were also found playing a big role. Curve fitting showed that quasi-circular stones had a high risk of retropulsion, and eventually led to stone left. Finally, stone length, shape, modality, and the distance of stones to the ureteropelvic junction were enrolled in the model. Among them, the distance of the stone to the ureteropelvic junction showed a noticeable impact on stone left. AUC was 0.803 (95% CI: 0.730-0.876), and the calibration curve showed good calibration of the model (concordance index, 0.792). DCA indicated the model added net benefit to patients. Conclusions:The present predictive model based on those factors, stones length, shape, modality, and distance of the stone to the ureteropelvic junction was easy, reliable and useful.

show abstract

Section: Discussionmentioning

confidence: 92%

A simple predictive model with internal validation for assessment of stone-left after ureteroscopic lithotripsy in upper ureteral stones

Zhang

et al. 2022

Transl Androl Urol

View full text Add to dashboard Cite

show abstract

“…score defined by Hori et al [ 12 ], S.T.O.N.E score defined by Molina et al [ 11 ], and modified T.O.HO. score defined by Polat et al [ 13 ] in predicting RIRS success was evaluated by ROC analysis by using our datas. Among these scoring systems, T.O.HO.…”

Section: Resultsmentioning

confidence: 99%

“…In this study, modified T.O.HO. score was shown to predict the RIRS success better than the original version [ 13 ]. But in our study, T.O.HO.…”

Section: Discussionmentioning

confidence: 99%

External validation of the T.O.HO. score as predictor of success after retrograde intrarenal surgery

et al. 2022

View full text Add to dashboard Cite

Background To assess the effectiveness of T.O.HO. (Tallness, Occupied lesion, Houndsfield unit evaluation) score in predicting the retrograde intrarenal surgery (RIRS) success and to validate this scoring system. Methods The age, sex, previous stone surgery, hospitalization, surgery duration, postoperative complication, stone length, stone location, stone density, stone number, lateralization, presence of hydronephrosis, and presence of preoperative stent datas of 611 patients who underwent RIRS in our clinic between January 2013 and January 2021 were retrospectively assessed. The patients were divided into two groups as successful and unsuccessful. The T.O.HO scores of all patients were calculated. Results The success rate was 72.5%. Compared to the unsuccessful group, stone length and stone density were lower, surgery duration was shorter and there were less lower pole stones in the successful group (p < 0.001). No significant difference was found between the two groups in terms of the other parameters. The T.O.HO. score was significantly lower in the successful group compared to the unsuccessful group (p < 0.001). According to the multivariate logistic regression analysis, stone length (OR: 0.905; 95% Cl: 0.866–0.946; p < 0.001), lower pole location (OR: 0.546; 95% Cl: 0.013–0.296; p < 0.001), stone density (OR: 0.999; 95% Cl: 0.998–1; p = 0.044) and the T.O.HO. score (OR: 0.684; 95%Cl: 0.554–0.844; p < 0.001) were found as the independent risk factors for RIRS success. ROC curve analysis showed that the T.O.HO. score could predict the RIRS success with 7.5 cut-off point (AUC: 0.799, CI: 0.76–0.839; p < 0.001). Conclusion The T.O.HO. score can predict RIRS success with a high rate of accuracy.

show abstract

“…This may also be applied to predict surgical efficacy. Larger volume stones are associated with a lower stone-free rate after SWL [84,95–97] and ureteroscopy [85,98,99], as well as higher complication rates [100] and longer operative time for ureteroscopy [85,98,101]. For PCNL, larger volume stones are associated with lower stone free rate and need for second procedure [83], increased operating time [83,88,102], increased lasering time [101], higher complication rates [88], decreased hematocrit [88,102], and need for secondary procedure.…”

Section: Ct Assessment Of Stones For Management Planningmentioning

confidence: 99%

Imaging in stone diagnosis and surgical planning

Serrell

Best

2022

Current Opinion in Urology

View full text Add to dashboard Cite

Purpose of reviewRadiological imaging techniques and applications are constantly advancing. This review will examine modern imaging techniques in the diagnosis of urolithiasis and applications for surgical planning. Recent findingsThe diagnosis of urolithiasis may be done via plain film X-ray, ultrasound (US), or contrast tomography (CT) scan. US should be applied in the workup of flank pain in emergency rooms and may reduce unnecessary radiation exposure. Low dose and ultra-low-dose CT remain the diagnostic standard for most populations but remain underutilized. Single and dual-energy CT provide three-dimensional imaging that can predict stone-specific parameters that help clinicians predict stone passage likelihood, identify ideal management techniques, and possibly reduce complications. Machine learning has been increasingly applied to 3-D imaging to support clinicians in these prognostications and treatment selection.

show abstract

External validation of the T.O.HO. score and derivation of the modified T.O.HO. score for predicting stone-free status after flexible ureteroscopy in ureteral and renal stones

Cited by 3 publications

References 27 publications

A simple predictive model with internal validation for assessment of stone-left after ureteroscopic lithotripsy in upper ureteral stones

A simple predictive model with internal validation for assessment of stone-left after ureteroscopic lithotripsy in upper ureteral stones

External validation of the T.O.HO. score as predictor of success after retrograde intrarenal surgery

Imaging in stone diagnosis and surgical planning

Contact Info

Product

Resources

About