Predicting stone free rate after retrograde intrarenal surgery using RIRS scoring system versus Resorlu Unsal stone score (RUSS)

Abstract

Background To evaluate the predictive ability of the RIRS scoring system and the RUSS in predicting stone-free rate (SFR) after retrograde intrarenal surgery (RIRS). Methods This prospective study was conducted on patients who underwent RIRS for kidney stones. Two scoring systems were used to determine the degree of procedure difficulty: the RIRS scoring system and the RUSS. We assessed the predictive ability of the two scoring systems utilizing receiver operating characteristic (ROC) analysis and calculated the sensitivity and specificity of each system. Additionally, we analyzed the association between the scoring systems and the stone-free outcome using a multivariate logistic regression model. Results One hundred seventy-one patients were incorporated into this study with a mean age of 43 years, and 65.5% were male. The results showed a significant AUC of 0.868 for the RIRS score ( P < 0.001, 95% CI = 0.813–0.924). The sensitivity and specificity were 72% and 93.7%, respectively. In contrast, the RUSS score revealed a non-significant unsatisfactory AUC of 0.480 ( P = 0.660), with a 95% confidence interval ranging from 0.384–0.576. Conclusion The RIRS scoring system showed a better predictive ability for SFR after RIRS than the RUSS. Additionally, RIRS was a significant predictor of SFR, controlling for age, gender, body mass index, and previous renal surgery.

Assessment of Factors Responsible for Stone-Free Status After Retrograde Intrarenal Surgery

“…The diagnostic accuracy of this score was reasonably high, with an AUC of 0.882 (95% CI: 0.828-0.936). Our findings are in agreement with a study by Elmohamady et al in which the RIRS score had a satisfactory AUC of 0.868 [ 6 ].…”

“…The success of RIRS is determined by the stone-free rate (SFR), auxiliary procedures needed, and complications. Multiple diverse factors govern SFRs in RIRS, such as stone burden, stone density, stone location, number of stones, and calyceal anatomy [ 6 ]. Reported SFR rates for RIRS vary from 54% to 96% for renal stones smaller than 2 cm [ 7 ].…”