Utility of the Guy's Stone Score on real world outcomes of suction mini-PCNL in 1527 adult patients with normal collecting system anatomy. A prospective multicenter study from the EAU section of Endourology and Asian Urological Society of Endoluminal Surgery and Technology collaboration

Issued Date

2026-04-01

Resource Type

Article

eISSN

27246442

DOI

10.23736/S2724-6051.25.06632-7

Scopus ID

2-s2.0-105036632553

Pubmed ID

41553791

Journal Title

Minerva Urology and Nephrology

Volume

78

Issue

2

Start Page

265

End Page

274

Rights Holder(s)

SCOPUS

Bibliographic Citation

Minerva Urology and Nephrology Vol.78 No.2 (2026) , 265-274

Suggested Citation

Gauhar V., Yuen S.K., Zawadzki M., Lim E.J., Innoue T., Taguchi K., Fong K.Y., Kalathia J., Tak G.R., Lakmichi M.A., Shwani Y.A., Tan K., Ketsuwan C., Kamal W., Kumar N., Mehta A., Heng C.T., Laymon M., Omar M., Kalbit R.H., Chai C.A., Mohan V.C., Gadzhiev N., Malkhasyan V., Cepeda Delgado M., Baker A., Salah M., Zeng G., Sarica K., Giulioni C., Herrmann T.R., Somani B.K., Castellani D. Utility of the Guy's Stone Score on real world outcomes of suction mini-PCNL in 1527 adult patients with normal collecting system anatomy. A prospective multicenter study from the EAU section of Endourology and Asian Urological Society of Endoluminal Surgery and Technology collaboration. Minerva Urology and Nephrology Vol.78 No.2 (2026) , 265-274. 274. doi:10.23736/S2724-6051.25.06632-7 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116485

Title

Utility of the Guy's Stone Score on real world outcomes of suction mini-PCNL in 1527 adult patients with normal collecting system anatomy. A prospective multicenter study from the EAU section of Endourology and Asian Urological Society of Endoluminal Surgery and Technology collaboration

Author(s)

Gauhar V.
 Yuen S.K.
 Zawadzki M.
 Lim E.J.
 Innoue T.
 Taguchi K.
 Fong K.Y.
 Kalathia J.
 Tak G.R.
 Lakmichi M.A.
 Shwani Y.A.
 Tan K.
 Ketsuwan C.
 Kamal W.
 Kumar N.
 Mehta A.
 Heng C.T.
 Laymon M.
 Omar M.
 Kalbit R.H.
 Chai C.A.
 Mohan V.C.
 Gadzhiev N.
 Malkhasyan V.
 Cepeda Delgado M.
 Baker A.
 Salah M.
 Zeng G.
 Sarica K.
 Giulioni C.
 Herrmann T.R.
 Somani B.K.
 Castellani D.

Author's Affiliation

Chinese University of Hong Kong
 Universiti Malaya
 Hannover Medical School
 Stellenbosch University
 Menoufia University
 Singapore General Hospital
 University Hospital Southampton NHS Foundation Trust
 Faculty of Medicine
 Hamad Medical Corporation
 The First Affiliated Hospital of Guangzhou Medical University
 Ramathibodi Hospital
 Hospital Universitario Río Hortega
 Biruni Üniversitesi
 College of Medicine, Qatar University
 CHU Mohammed-VI
 Sengkang General Hospital
 Kantonsspital Frauenfeld
 King Fahd General Hospital
 European Association of Urology
 Saint-Petersburg State University Hospital
 Nagoya City University East Medical Center
 Ng Teng Fong General Hospital
 Jose R. Reyes Memorial Medical Center
 Botkin Hospital
 Hara Genitourinary Hospital
 St. Anna Hospital
 Erbil Teaching Hospital
 Ford Hospital and Research Centre
 Fortune Urology Clinic
 Urology Unit
 B.T. Savani Kidney Hospital
 Veterans Memorial Medical Center
 Preeti Urology and Kidney Hospital
 Asian Institute of Nephrology & Urology

Corresponding Author(s)

Gauhar V.

Other Contributor(s)

Mahidol University

Abstract

BACKGROUND: Guy's Stone Score (GSS) has proven to be the most reliable and valuable tool for predicting the success rate and potential complications after percutaneous nephrolithotomy (PCNL) This study aims to assess the impact of GSS on perioperative outcomes, complications and stone-free rates (SFR) in adult patients undergoing suction mini-percutaneous (SM)-PCNL for kidney stone(s). METHODS: Data from 1527 adult patients with normal renal anatomy who underwent prone or supine SM-PCNL across 21 countries were analyzed. Patients were stratified by GSS (1-4) based on preoperative CT imaging. The primary outcome was 30-day SFR, assessed by non-contrast CT, defined as zero fragment. Secondary outcomes included peri- and postoperative complications. Multivariate analysis identified predictors of SFR and complications. RESULTS: Despite increased complexity, SM-PCNL was frequently utilized for GSS 3 and 4 cases, often requiring multiple tracts and advanced access techniques. Complication rates, including bleeding and infectious events, were low but significantly higher in GSS 3 and 4 groups. SFR decreased with increasing GSS, with GSS 1 achieving the highest rates and GSS 4 the lowest. Multivariate analysis identified stone volume (OR 0.96), and GSS 2 (OR 0.53), 3 (OR 0.27) and 4 (OR 0.46) as independent predictors of lower odds of zero residual fragment compared to GSS 1, while sheath size 16-18 Fr (OR 1.72) and <18 Fr (OR 4.48) with higher odds compared to sheath size <16 Fr. GSS 2 (OR 2.22), 3 (OR 4.97) and 4 (OR 4.01) compared to GSS 1 and mechanical lithotripsy (OR 1.65) were associated with higher odds of all complications compared to laser lithotripsy. CONCLUSIONS: GSS effectively predicts perioperative outcomes following suction mini-PCNL. Increasing stone complexity is associated with reduced SFR and higher complication rates, underscoring the importance of preoperative risk stratification, tailored surgical planning and a proper informed consent for the patient in complex cases.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/123456789/116485

Collections

Scopus 2026