Guy’s Stone Score (GSS) Based on Intravenous Pyelogram (IVP) Findings Predicting Upper Pole Access Percutaneous Nephrolithotomy (PCNL) Outcomes

Abstract

Objective. To predict the success rate and complications following percutaneous nephrolithotomy via the upper pole using the Guy's Stone Score (GSS) based on the findings of a preoperative intravenous pyelogram (IVP). Patients and Methods. Two hundred and twenty-seven renal operations, which were carried out using PCNL via the upper pole, were classified according to the GSS assigned. Any complications were classified according to the Clavien classification. The success rates and incidence of any complications were compared between each GSS. Results. The immediate success rates were 87.50% of GSS1, 71.43% of GSS2, 53.62% of GSS3, and 38.46% of GSS4, P < 0.01. There were statistically significant differences between the groups in stone size, overall immediate success rate, operative time, number of access tracts, and frequency of tubeless PCNL. Major complications (a Clavien score of 3–5) were significantly higher in the cases with a higher GSS. Conclusion. A GSS based on an IVP is a simple and reliable tool in predicting the success rate and possible complications following upper pole access PCNL.

A prospective, single-centered, cohort study comparing the treatment of renal stones by following PCNL types: Standard, tubeless & totally tubeless

“…These results are similar to those of our study, as GSS-1 had the highest success rate of 87.4%, GSS-2 had 52.4%, GSS-3 had 48.4% and GSS-4 showed the lowest success rate of 4.3%. Clavien-Dindo classification in our study was also comparable to the Thailand study [ 37 ], as major complications (Clavien score of 1–2) were significantly higher in the cases with a higher GSS while minor complications (Clavien score of 3a-5) were significantly lower in patients with lower GSS. Tubeless PCNL entails a benefit over the standard PCNL in terms of shorter hospital stay and early recovery time in patients [ 38 ].…”

“…To predict the success rate and complications following PCNL, GSS is used. According to a study done in Thailand, the success rates were found to be 87.5% for GSS-1, 71.4% for GSS-2, 53.6% for GSS-3, and 38.5% for GSS-4 [ 37 ]. These results are similar to those of our study, as GSS-1 had the highest success rate of 87.4%, GSS-2 had 52.4%, GSS-3 had 48.4% and GSS-4 showed the lowest success rate of 4.3%.…”

Treatment of renal stones by standard percutaneous nephrolithotomy versus modified mini percutaneous nephrolithotomy in Yala Hospital: A comparative study

“…A 20 Fr nephrostomy catheter was inserted and kept postoperatively till hematuria recovered. Postoperative chest x-ray was obtained in case of upper calyx access for the assessment of any pulmonary complications 5 . For the MM-PCNL group, the same procedure as S-PCNL was performed with some changes in tract dilatation and nephroscope.…”

Radiological investigations in nephrolithiasis and: a narrative review

“…When performing percutaneous nephrolithotomy (PCNL) to remove complex renal and upper ureteric stones from the upper pole of the kidney, the success rates and possible complications are assessed using Guy's Stone Score (GSS). Hence, GSS, based on IVP interpretation, is a reliable and simple tool for predicting the outcome, assisting in pre-operative planning, and counselling the patient [5].…”