Modified Seoul National University Renal Stone Complexity score for retrograde intrarenal surgery

Abstract

The Seoul National University Renal Stone Complexity (S-ReSC) score is a well-validated tool for the prediction of stone-free rate (SFR) after percutaneous nephrolithotomy. We modified the S-ReSC score system for application to retrograde intrarenal surgery (RIRS) and evaluated this score. A total of 88 patients who underwent RIRS from 2011 to 2013 were included. The modified S-ReSC score was assigned according to the number of sites involved in the renal pelvis (#1), superior and inferior major calyceal groups (#2-3), and anterior and posterior minor calyceal groups of the superior (#4-5), middle (#6-7), and inferior calyx (#8-9). If the stone was in the inferior sites (#3, #8-9), one additional point per site was added to the original score. The SFR was examined according to the modified S-ReSC score. To evaluate the predictive accuracy, the area under the receiver operating characteristic curve (AUC) was used and compared with the Resorlu-Unsal Stone (RUS) score. The SFR was 85.2% and was significantly decreased in the order of low (1-2: 94.2%), medium (2-4: 84.0%), and high (>4: 45.5%) modified ReSC score groups (p < 0.001). AUCs of the modified S-ReSC score (0.806) and score group (0.766) were higher than the AUC of the RUS score (0.692; p = 0.012 and p = 0.040, respectively). The modified S-ReSC score predicts the SFR after RIRS well. Furthermore, its predictive accuracy is higher than that of the RUS score.

Retrograde intrarenal surgery for renal stones - Part 2

“…Similarly, Jung et al [3] developed another scoring system for RIRS called the Modified Seul National University Renal Stone Complexity (S-ReSC) scoring system. This scoring system is based on the number of sites of renal stones involved.…”

“…If the stone is located in the inferior calyceal area (#3, #8-9), one additional point per site is added to the original score. The modified S-ReSC score, which differs between 1-12, is classified into low (1-2 points), intermediate (3)(4) or high (>4) groups, where SFRs are 94.2, 84 and 45.5% for these groups respectively. The advantage of this scoring system is that it was externally validated for the first time and its predictive accuracy was shown to be better than that of the Resorlu-Unsal Stone Scoring system.…”

“…The advantage of this scoring system is that it was externally validated for the first time and its predictive accuracy was shown to be better than that of the Resorlu-Unsal Stone Scoring system. Park et al [4] performed its external validation, and found SFRs as 86.7, 70.2 and 48.6% for low (1-2), intermediate (3)(4) and high (5-12) score groups respectively. Both scoring systems have been helpful for separating patients into outcome groups and for determining treatment plans.…”

Predictive factors on success after flexible ureterorenoscopy

“…We have read with great interest the article entitled 'Modified Seoul National University Renal Stone Complexity score for retrograde intrarenal surgery' by Jung et al [1]. The authors analyzed 88 patients who underwent flexible ureterorenoscopy (f-URS) and developed a new nomogram called the modified Seoul National University Renal Stone Complexity (S-ReSC) score to predict stone-free (SF) after fURS.…”

“…Jung JW, Lee BK, Park YH, Lee S, Jeong SJ, Lee SE et al (2014) Modified Seoul National University renal stone complexity score for retrograde intrarenalsurgery. Urolithiasis 42:335-340 2.…”