Jones P. et al., 2021: Atlas of scoring systems, grading tools and nomograms in Endourology: A comprehensive overview from The TOWER Endourological Society research group.
Jones P, Pietropaolo A, Chew BH, Somani BK.
Haukeland University Hospital, 60498, Urology, Bergen, Norway.
University Hospital Southampton NHS Foundation Trust, 7425, Urology, Southampton, Southampton , United Kingdom of Great Britain and Northern Ireland.
University of British Columbia, Urologic Sciences, Vancouver, British Columbia, Canada.
University Hospital Southampton NHS Foundation Trust, 7425, Urology, Southampton, Southampton , United Kingdom of Great Britain and Northern Ireland.
University of Southampton, 7423, Southampton, Hampshire, United Kingdom of Great Britain and Northern Ireland.
Abstract
Introduction: With an increase in the prevalence of kidney stone disease (KSD), there has been a universal drive to develop reliable and user-friendly tools such as grading systems and predictive nomograms. An atlas of scoring systems, grading tools and nomograms in Endourology is provided in this paper.
Methods: A comprehensive search of world literature was performed to identify nomograms, grading systems and classification tools in endourology related to KSD. Each of these were reviewed by the authors and have been evaluated in a narrative format with details on those which are externally validated and their respective citation count on google scholar.
Results: A total of 54 endourological tools have been described in our atlas of endourological scoring systems, grading tools and nomograms. Of the tools, 23 (43%) are published in the last 3 years showing an increasing interest in this area. This includes 5 for percutaneous nephrolithotomy (PCNL), 6 for flexible ureteroscopy (fURS), 3 for semi-rigid URS (sURS), 9 for shockwave lithotripsy (SWL), 2 for stent encrustations, 3 for intra-operative appearance at the time of URS and 3 to classify intra-operative ureteric injury. There were 3 tools for renal colic assessment, one each for prediction of future stone event, stone classification and stone impaction and 2 for need of emergency intervention in ureteric stone. While 2 tools are related to stone recurrence, 6 are related to post-procedural complications. There are now 2 tools for simulation in endourology and 5 for patient reported outcome measures (PROMS).
Conclusions: A number of reliable and established tools exist currently in endourology. Each of these offers their own respective advantages and disadvantages. While nomograms and scoring systems can help in the decision making, these must be tailored to individual patients based on their specific clinical scenarios, expectations and informed consent.
J Endourol. 2021 Apr 20. doi: 10.1089/end.2021.0124. Online ahead of print. PMID: 33878937
Comments 1
Two scoring systems for ESWL are mentioned with some details, the S3HoCKwave score (1) and the Triple D score (2). Of the nine scores for ESWL mentioned in a tabular form only the Triple D score is externally validated by two groups fromTurkey (3,4) with similar results. I do not know why they call the present narrative review an atlas. The profit for the reader is the compilation of available scores.
1 Toshioka T, Ikenoue T, Hashimoto H, et al; S.W.L. Study Group. Development and validation of a prediction model for failed shockwave lithotripsy of upper urinary tract calculi using computed tomography information: the S3HoCKwave score. World J Urol. 2020 Feb 22. doi: 10.1007/s00345-020-03125-y. Epub ahead of print. PMID: 32088747
2 Tran TY, McGillen K, Cone EB, Pareek G. Triple D Score is a reportable predictor of shockwave lithotripsy stone-free rates. J Endourol. 2015 Feb;29(2):226-30. doi: 10.1089/end.2014.0212. Epub 2014 Sep 19. PMID: 25046472.
3 Gökce MI, Esen B, Gülpınar B, Süer E, Gülpınar Ö. External Validation of Triple D Score in an Elderly (≥65 Years) Population for Prediction of Success Following Shockwave Lithotripsy. J Endourol. 2016 Sep;30(9):1009-16. doi: 10.1089/end.2016.0328. Epub 2016 Jul 28. PMID: 27392789.
4 Ozgor F, Tosun M, Kayali Y, Savun M, Binbay M, Tepeler A. External Validation and Evaluation of Reliability and Validity of the Triple D Score to Predict Stone-Free Status After Extracorporeal Shockwave Lithotripsy. J Endourol. 2017 Feb;31(2):169-173. doi: 10.1089/end.2016.0721. Epub 2017 Jan 4. PMID: 27889982.
Peter Alken