Agreement Between Visual Assessment of Urinary Stones Morphology During Endo-Urological Procedure and Fourier...

Area of Science:

• Urology
• Nephrology
• Analytical Chemistry

Background:

• Urolithiasis, or kidney stones, poses a significant clinical challenge.
• Accurate stone composition analysis is crucial for effective treatment and prevention strategies.
• Visual assessment during endourological procedures offers a rapid, albeit potentially less precise, method for estimating stone type.

Purpose of the Study:

• To evaluate the accuracy of visual assessment in predicting urinary stone composition during endourological procedures.
• To compare the predictive accuracy of surgeons with varying experience levels.
• To establish Fourier transform infrared spectroscopy (FTIR) as a reference standard for stone analysis.

Main Methods:

• A prospective observational study involving 150 patients undergoing endourological procedures for urolithiasis.
• Visual assessment of stone morpho-constitution (Daudon classification) by senior consultants, junior consultants, and residents.
• Stone sample analysis using Fourier transform infrared spectroscopy (FTIR) for definitive composition determination and correlation with visual assessments.

Main Results:

• Fourier transform infrared spectroscopy identified 18.67% pure stones and 81.33% mixed-composition stones.
• Accurate predictions for pure uric acid and protein stones were 84.31% and 83.33%, respectively.
• The overall correct visual prediction rate was 64.44%, with senior consultants achieving the highest accuracy (73.33%).

Conclusions:

• Visual assessment of urinary stone morphology during endourological procedures demonstrates moderate agreement with FTIR-based composition analysis (Cohen's kappa = 0.62).
• Surgeon experience significantly influences the accuracy of visual stone composition prediction.
• While valuable, visual assessment should be complemented by objective analysis for precise urolithiasis management.