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Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Urinary Tract Calculi III: Medical Management01:30

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Urinary Tract Calculi IV: Nutrition Therapy and Prevention01:27

Urinary Tract Calculi IV: Nutrition Therapy and Prevention

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Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...
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Urinary Tract Calculi V: Nursing Management01:28

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AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
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Urinary Tract Calculi I: Introduction01:28

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Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
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Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations

346
Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Correlation between S.T.O.N.E score and channel size selection in percutaneous nephrolithotomy.

Lei Gao1, Mingyue Zeng2,3, Tiejun Pan1

  • 1Department of Urology, General Hospital of Central Theater Command of Chinese People's Liberation Army, Wuhan, 430070, China.

International Urology and Nephrology
|December 23, 2025
PubMed
Summary

The S.T.O.N.E. score effectively guides percutaneous nephrolithotomy (PCNL) access tract size. High S.T.O.N.E. scores benefit from standard tracts for better stone clearance, while low scores are safer with mini-tracts.

Keywords:
Clavien classificationPercutaneous nephrolithotomy (PCNL)Predictive modelRenal calculusS.T.O.N.E. scoring systemStone-free rate (SFR)Tract size

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Area of Science:

  • Urology
  • Nephrology
  • Surgical Innovation

Background:

  • Percutaneous nephrolithotomy (PCNL) is a key procedure for kidney stone removal.
  • Access tract size selection impacts PCNL outcomes.
  • The S.T.O.N.E. nephrolithiasis scoring system aims to predict stone complexity.

Purpose of the Study:

  • To assess the predictive value of the S.T.O.N.E. score for guiding PCNL access tract size.
  • To evaluate the influence of S.T.O.N.E. score-based tract selection on stone-free rates and complications.

Main Methods:

  • Retrospective analysis of 323 PCNL patients.
  • Classification into high (9-13) and low (5-8) S.T.O.N.E. score groups.
  • Comparison of standard-tract PCNL (SPCNL) vs. mini-tract PCNL (MPCNL) outcomes (stone-free rate, complications).

Main Results:

  • High S.T.O.N.E. score group: SPCNL showed higher stone-free rates (72.6% vs. 33.3%) and shorter operative times than MPCNL, with similar severe complication rates.
  • Low S.T.O.N.E. score group: SPCNL and MPCNL had comparable stone-free rates and operative times, but MPCNL had significantly fewer severe complications (12.7% vs. 28.7%).
  • Multivariate analysis identified S.T.O.N.E. score and operative time as risk factors for residual stones, while larger tract size was protective.

Conclusions:

  • The S.T.O.N.E. score is a significant factor in PCNL access tract selection.
  • Standard tracts are recommended for high S.T.O.N.E. score patients for improved efficacy.
  • Mini-tracts are associated with fewer complications in low S.T.O.N.E. score patients, suggesting personalized approach.
  • The S.T.O.N.E. score aids in tailoring PCNL procedures for optimal outcomes.