Is there a superiority of the stone volume measured in 3-D non-contrast tomography to the stone area in predicting the stone-freeness of the retrograde intrarenal surgery success?

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KAYNAK Y., Kılıçarslan H., Ökeer E., Coskun B.

Pamukkale Tıp Dergisi, vol.16, no.2, pp.258-264, 2023 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 16 Issue: 2
  • Publication Date: 2023
  • Doi Number: 10.31362/patd.1190940
  • Journal Name: Pamukkale Tıp Dergisi
  • Journal Indexes: Scopus, Central & Eastern European Academic Source (CEEAS), TR DİZİN (ULAKBİM)
  • Page Numbers: pp.258-264
  • Bursa Uludag University Affiliated: Yes


Purpose: To examine the predictive effect of preoperative stone volume (SV) against stone area (SA) on stone- free status (SF) following retrograde intrarenal surgery (RIRS). Materials and methods: We retrospectively examined the medical records of 68 RIRS patients with renal calculi who were eligible. Patients having Non-Contrast Tomography (NCCT) before and subsequent to RIRS were included, however staghorn stones and inability to access were omitted. SF status was determined by the absence of visible stones on the NCCT three months after RIRS. Using a software reconstruction tool using 3-D NCCT, a radiologist determined stone load characteristics, such as SA and SV. Using a logistic regression model, the assessment of potential SF status determinants was conducted. Results: Age, stone density, quantity and position of stones, usage of access sheath, failed prior SWL, and procedures were not substantially linked with non-SF status, however gender (p=0.014), SA (p=0.001), and SV (p=0.002) were strongly associated with non-SF status. The association between SV and SA was strong (r=0.866, p<0.001). A pairwise assessment of the ROC curves for SV and SA revealed no statistically significant difference in their specificities (p=0.274). Nevertheless, the multivariate analysis showed that SA was the sole independent predictor of SF status (p=0.001). Conclusions: Both SA and SV were strongly suggestive of SF status after the RIRS. However, SA was only identified as an independent predictor of SF status after RIRS and as a sufficient predictor of SF status after RIRS.