Modified Seoul National University Renal Stone Complexity Scoring System for Predicting Stone-Free Status After Extracorporeal Shock Wave Lithotripsy
Tipatai Yodplob,1 Chinnakhet Ketsuwan2 1Department of Surgery, Ranong Hospital, Ranong, Thailand; 2Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Chinnakhet Ketsuwan, Email chinnakhet.ket@mahidol.ac.thBackground: Incorporating th...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2025-08-01
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| Series: | Research and Reports in Urology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/modified-seoul-national-university-renal-stone-complexity-scoring-syst-peer-reviewed-fulltext-article-RRU |
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| Summary: | Tipatai Yodplob,1 Chinnakhet Ketsuwan2 1Department of Surgery, Ranong Hospital, Ranong, Thailand; 2Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Chinnakhet Ketsuwan, Email chinnakhet.ket@mahidol.ac.thBackground: Incorporating the modified Seoul National University Renal Stone Complexity (S-ReSC-R) scoring system into the preoperative evaluation of both retrograde intrarenal surgery and percutaneous nephrolithotomy has proven to be highly effective in predicting stone-free status after each procedure.Objective: This study aimed to validate the S-ReSC-R scoring system in extracorporeal shock wave lithotripsy (ESWL) and compare it with the Triple D score under the same protocol.Materials and Methods: Data on consecutive patients undergoing ESWL at a tertiary referral center between 2019 and 2021 were retrospectively analyzed. A total of 297 patients who were evaluated with non-contrast CT prior to the procedure and had adequate follow-up data were included in the analysis. The S-ReSC-R score was calculated based on the number of sites affected. Stone-free status was defined as no evidence of residual stones. Receiver operator characteristic (ROC) curves were generated to determine cutoff values for both scoring systems.Results: The overall stone-free rate (SFRs) after a single session was 60.5%. The average S-ReSC-R score was significantly lower in patients who had successful ESWL than in those with failed ESWL (1.50 vs 2.63, p < 0.001). The SFRs were significantly lower with higher S-ReSC-R scores: 72.4% in the low score (1– 2) group, 36.0% in the intermediate score (3– 4) group, and 10.5% in the high score (5– 12) group (p < 0.001). Multivariate analyses revealed that both the S-ReSC-R score and the Triple D score independently influenced ESWL success (both p < 0.001). The area under the ROC curve for the S-ReSC-R score was 0.767, whereas that for the Triple D score was 0.694.Conclusion: This study confirms that the S-ReSC-R is a reliable tool for predicting stone-free status after ESWL. Thus, its use in evaluating patients for ESWL is recommended.Keywords: extracorporeal shock wave lithotripsy, S-ReSC-R, stone-free status, Triple D |
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| ISSN: | 2253-2447 |