Comparative assessment of old and new treatment evaluation criteria in urolithiasis

Abstract

  According to the new treatment evaluation criteria of urolithiasis in 2015, residual stone ratio was recommended to determine the therapeutic efficacy in association with the recording stone size in volume. We retrospectively assessed the association of treatment evaluation by the old and new criteria with the prognosis in 64 kidneys treated by TUL-assisted PNL (TAP). According to the old criteria, two-year recurrence-free rates of “no residual stone”, “residual stone ≤4.0mm” and “residual stone ≥4.1mm” were clearly stratified (p=0.01 ; 92.3%, 66.1% and 58.2%, respectively). In contrast, according to the new criteria, two-year recurrence-free rates of “no residual stone”, “residual stone <5%” and “residual stone ≥5%” were not significantly different (p=0.05 ; 92.2%, 60.3% and 64.3%, respectively), and the stratification of the latter two groups was especially poor. In conclusion, treatment evaluation by residual stone ratio might not reflect the prognosis in cases with relatively large stones treated with TAP.