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T.O.HO.-PCNL Score for Predicting Success of Percutaneous Nephrolithotripsy: A New Score Development Study.

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A modified T.O.HO. score, the T.O.HO.-PCNL, effectively predicts percutaneous nephrolithotomy (PCNL) success. This new scoring system aids in preoperative evaluation for stone-free outcomes after PCNL.

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Area of Science:

  • Urology
  • Nephrology
  • Surgical Outcomes

Background:

  • Percutaneous nephrolithotomy (PCNL) is a key procedure for kidney stone removal.
  • Predicting PCNL success is crucial for patient management and surgical planning.
  • Existing scoring systems may not fully capture the complexities of PCNL.

Purpose of the Study:

  • To develop and validate a modified T.O.HO. score, termed T.O.HO.-PCNL, for predicting the success of percutaneous nephrolithotomy.
  • To improve the accuracy of preoperative assessment for PCNL outcomes.

Main Methods:

  • A retrospective review of 155 patients undergoing PCNL was conducted.
  • The T.O.HO. score was modified, specifically restructuring the stone location parameter.
  • The T.O.HO.-PCNL score's predictive performance was assessed using ROC curve analysis.

Main Results:

  • The overall PCNL success rate was 65.8%.
  • Smaller stone size was an independent predictor of PCNL success (OR: 1.076).
  • The T.O.HO.-PCNL score demonstrated predictive value for PCNL success (AUC: 0.598).

Conclusions:

  • The T.O.HO.-PCNL scoring system is a promising tool for predicting stone-free status post-PCNL.
  • This nomogram can aid in the preoperative evaluation of patients undergoing PCNL.
  • Further validation may enhance its clinical utility in surgical planning.