COMPARING THE EFFICACY OF CONVENTIONAL S.T.O.N.E. SCORING SYSTEM (SS) & MODIFIED S.T.O.N.E. SCORING SYSTEM (MSS) IN PREDICTING THE OUTCOMES OF PCNL

Abstract

Background: PCNL is the standard procedure for managing renal stones, with various scoring systems developed to predict its outcomes. This study utilized the Modified S.T.O.N.E. Scoring System (MSS), based on U/S KUB and X-ray KUB, in contrast to the conventional S.T.O.N.E Scoring System (SS), which relies on CT KUB. Objective: To compare the efficacy of Conventional S.T.O.N.E. Scoring System (SS) and Modified S.T.O.N.E Scoring System (MSS) in predicting the stone free rate (SFR) and post-operative complications in patients undergoing percutaneous nephrolithotomy (PCNL). Methodology: This prospective, interventional comparative study was conducted at Tabba Kidney Institute on adult patients clinically and radiologically diagnosed with renal stones. Using randomization software, patients were assigned to two groups: Group A underwent CT KUB, while Group B had U/S KUB and X-ray KUB. Demographic and perioperative data were recorded, and all patients underwent prone PCNL. Procedure efficacy was assessed by the stone-free rate (SFR) on U/S KUB at 4 weeks postoperatively. Statistical analysis was performed using SPSS version 23. Results: The mean age was 42.8 ± 14.6 years and 57% were males. 90% patients were presented with flank pain. Overall stone free rates were reported as 86% in SS and 90% in MSS. The p-value was reported as significant for all variables except MSS residual stone as 0.598. Conclusion: The Modified S.T.O.N.E. Scoring System (MSS) demonstrated higher stone-free rates and greater efficacy in predicting PCNL outcomes, with reduced radiation exposure and improved cost-effectiveness compared to the conventional S.T.O.N.E. Scoring System (SS). Therefore, MSS is recommended as a first-line tool in renal stone management.