ObjectivesCurrently, no standardized method is available to predict success rate after percutaneous nephrolithotomy. We devised and validated the Seoul National University Renal Stone Complexity (S-ReSC) scoring system for predicting the stone-free rate after single-tract percutaneous nephrolithotomy (sPCNL).Patients and MethodsThe data of 155 consecutive patients who underwent sPCNL were retrospectively analyzed. Preoperative computed tomography images were reviewed. The S-ReSC score was assigned from 1 to 9 based on the number of sites involved in the renal pelvis (#1), superior and inferior major calyceal groups (#2–3), and anterior and posterior minor calyceal groups of the superior (#4–5), middle (#6–7), and inferior calyx (#8–9). The inter- and intra-observer agreements were accessed using the weighted kappa (κ). The stone-free rate and complication rate were evaluated according to the S-ReSC score. The predictive accuracy of the S-ReSC score was assessed using the area under the receiver operating characteristic curve (AUC).ResultsThe overall SFR was 72.3%. The mean S-ReSC score was 3.15±2.1. The weighted kappas for the inter- and intra-observer agreements were 0.832 and 0.982, respectively. The SFRs in low (1 and 2), medium (3 and 4), and high (5 or higher) S-ReSC scores were 96.0%, 69.0%, and 28.9%, respectively (p<0.001). The predictive accuracy was very high (AUC 0.860). After adjusting for other variables, the S-ReSC score was still a significant predictor of the SFR by multiple logistic regression. The complication rates were increased to low (18.7%), medium (28.6%), and high (34.2%) (p = 0.166).ConclusionsThe S-ReSC scoring system is easy to use and reproducible. This score accurately predicts the stone-free rate after sPCNL. Furthermore, this score represents the complexity of surgery.

No abstract

Aim: To compare the prostate volume, as measured by transrectal ultrasonography (TRUS) and by MRI, with that of the actual prostate volume measured after a radical prostatectomy (RRP). Materials and Methods: This prospective study included 21 patients who had undergone RRP. TRUS prostate volumes were calculated using the prolate ellipsoid volume formula, with the anteroposterior diameter measured from axial (TRUS-V1) and mid-sagittal images (TRUS-V2). Two prolate ellipsoid volumes (MRI-EV1 and MRI-EV2) were calculated from the MRI using the same method, and planimetric volume (MRI-PV). The actual prostate volume (Actual-V) was measured in a measuring jug within 1 h after RRP. Results: Mean of Actual-V was 40.3ml (21.0–82.0). In paired sample tests, the correlation coefficients (R) for all methods were over 0.8. In a Student’s t test (paired), MRI-PV (p = 0.620), MRI-EV2 (p = 0.703) and TRUS-V1 (p = 0.099) showed no significant differences compared to the Actual-V. The linear regression models of these three methods were y = 1.025x – 0.268, y = 0.946x + 2.979 and y = 1.046x + 0.381, respectively. Conclusions: Between two TRUS volumes, TRUS-V1 was shown to be superior to TRUS-V2. In MRI, MRI-EV2 was more accurate than MRI-EV1. However, MRI-PV was the most accurate method. TRUS-V1 and MRI-EV2 could be used instead of MRI-PV in general clinical settings.

RPN is a viable option as a nephron-sparing surgical procedure for SRMs considering the perioperative parameters and postoperative renal function changes, in addition to the traditional benefits of the laparoscopic procedure.

An elevated AST/ALT ratio was significantly associated with worse postoperative survival in patients surgically treated for localized clear-cell RCC. Further prospective studies are needed to understand the prognostic value of preoperative AST/ALT ratio.

Our results suggest that keeping a diary for 7 days may increase patient burden and thus, we recommend that the 7-day diary should be reduced to cover fewer days.

A significant proportion of patients with low-risk prostate cancer as defined by D'Amico et al.'s classification diagnosed via multi-core prostate biopsy in contemporary period may have Gleason score upgrading following RRP. For patients with low-risk prostate cancer, preoperative PSA level and number of positive cores may be useful predictors of Gleason score upgrading, which was observed to significantly associated with other adverse pathologic features.

No abstract