Introduction: We aimed to identify factors affecting percutaneous nephrolithotomy (PNL) outcomes among patients with horseshoe kidney (HSK) and assess the predictive accuracy of the Clinical Research Office of the Endourological Society (CROES), Guy’s Stone Score (GSS), and S.T.O.N.E. scoring systems. Methods: Data from 98 patients with HSK who underwent PNL between November 2010 and January 2020 were evaluated. Patients were divided into the stone-free (SF) and non-SF groups and compared according to demographic data, stone and surgical characteristics, and stone scoring systems. Multivariate logistic regression analysis was performed to identify factors associated with SF status. Results: Among the included patients, 87 were male and 11 were female (mean age: 47.37 ± 14.42 years). The SF rate was 84.7% (83 patients). Group analysis identified GSS (p < 0.001), CROES score (p < 0.001), S.T.O.N.E. score (p = 0.014), stone burden (p = 0.045), and multiplicity (p < 0.001) as factors associated with SF status. Among our cohort, 10 patients developed complications. All scoring systems were significantly correlated with SF status (CROES: r = −0.442, p < 0.001; GSS: r = 0.442, p < 0.001; S.T.O.N.E.: r = 0.250, p = 0.013), while CROES score was identified as an independent factor associated with SF status (95% CI: 0.937–0.987; p = 0.003). Conclusions: PNL is an effective method for treating nephrolithiasis among patients with HSK. Moreover, stone-related factors, such as larger size, multiplicity, and complexity, were associated with procedural failure. Finally, the CROES nomogram was a better predictor of SF status compared with other scoring systems.

1.
Weizer
AZ
,
Silverstein
AD
,
Auge
BK
,
Delvecchio
FC
,
Raj
G
,
Albala
DM
, et al.
Determining the incidence of horseshoe kidney from radiographic data at a single institution
.
J Urol
.
2003
;
170
(
5
):
1722
6
.
2.
Yohannes
P
,
Smith
AD
.
The endourological management of complications associated with horseshoe kidney
.
J Urol
.
2002
;
168
(
1
):
5
8
.
3.
Raj
GV
,
Auge
BK
,
Assimos
D
,
Preminger
GM
.
Metabolic abnormalities associated with renal calculi in patients with horseshoe kidneys
.
J Endourol
.
2004
;
18
(
2
):
157
61
.
4.
Chen
H
,
Chen
G
,
Pan
Y
,
Zhu
Y
,
Xiong
C
,
Chen
H
, et al.
No wound for stones
.
Urol Int
.
2019
;
103
(
3
):
249
55
.
5.
Sheir
KZ
,
Madbouly
K
,
Elsobky
E
,
Abdelkhalek
M
.
Extracorporeal shock wave lithotripsy in anomalous kidneys: 11-year experience with two second-generation lithotripters
.
Urology
.
2003
;
62
(
1
):
10
5
.
6.
Viola
D
,
Anagnostou
T
,
Thompson
TJ
,
Smith
G
,
Moussa
SA
,
Tolley
DA
.
Sixteen years of experience with stone management in horseshoe kidneys
.
Urol Int
.
2007
;
78
(
3
):
214
8
.
7.
Stein
RJ
,
Desai
MM
.
Management of urolithiasis in the congenitally abnormal kidney (horseshoe and ectopic)
.
Curr Opin Urol
.
2007
;
17
(
2
):
125
31
.
8.
Molimard
B
,
Al-Qahtani
S
,
Lakmichi
A
,
Sejiny
M
,
Gil-Diez de Medina
S
,
Carpentier
X
, et al.
Flexible ureterorenoscopy with holmium laser in horseshoe kidneys
.
Urology
.
2010
;
76
(
6
):
1334
7
.
9.
Atis
G
,
Resorlu
B
,
Gurbuz
C
,
Arikan
O
,
Ozyuvali
E
,
Unsal
A
, et al.
Retrograde intrarenal surgery in patients with horseshoe kidneys
.
Urolithiasis
.
2013
;
41
(
1
):
79
83
.
10.
Turk
C
,
Skolarikos
A
,
Neisius
A
,
Petrik
A
,
Seitz
C
,
Thomas
K
.
Guidelines on Urolithiasis
.
Available from
: https://uroweb.org/wp-content/uploads/EAU-Guidelines-on-Urolithiasis-2019.pdf
11.
Shokeir
AA
,
El-Nahas
AR
,
Shoma
AM
,
Eraky
I
,
El-Kenawy
M
,
Mokhtar
A
, et al.
Percutaneous nephrolithotomy in treatment of large stones within horseshoe kidneys
.
Urology
.
2004
;
64
(
3
):
426
9
.
12.
Miller
NL
,
Matlaga
BR
,
Handa
SE
,
Munch
LC
,
Lingeman
JE
.
The presence of horseshoe kidney does not affect the outcome of percutaneous nephrolithotomy
.
J Endourol
.
2008
;
22
(
6
):
1219
25
.
13.
Gupta
NP
,
Mishra
S
,
Seth
A
,
Anand
A
.
Percutaneous nephrolithotomy in abnormal kidneys: single-center experience
.
Urology
.
2009
;
73
(
4
):
710
4
.
14.
Ozden
E
,
Bilen
CY
,
Mercimek
MN
,
Tan
B
,
Sarikaya
S
,
Sahin
A
.
Horseshoe kidney: does it really have any negative impact on surgical outcomes of percutaneous nephrolithotomy?
Urology
.
2010
;
75
(
5
):
1049
52
.
15.
Skolarikos
A
,
Binbay
M
,
Bisas
A
,
Sari
E
,
Bourdoumis
A
,
Tefekli
A
, et al.
Percutaneous nephrolithotomy in horseshoe kidneys: factors affecting stone-free rate
.
J Urol
.
2011
;
186
(
5
):
1894
8
.
16.
Tepeler
A
,
Sehgal
PD
,
Akman
T
,
Unsal
A
,
Ozyuvali
E
,
Armagan
A
, et al.
Factors affecting outcomes of percutaneous nephrolithotomy in horseshoe kidneys
.
Urology
.
2014
;
84
(
6
):
1290
4
.
17.
Etemadian
M
,
Maghsoudi
R
,
Abdollahpour
V
,
Amjadi
M
.
Percutaneous nephrolithotomy in horseshoe kidney: our 5-year experience
.
Urol J
.
2013
;
10
(
2
):
856
60
.
18.
Tefekli
A
,
Ali Karadag
M
,
Tepeler
K
,
Sari
E
,
Berberoglu
Y
,
Baykal
M
, et al.
Classification of percutaneous nephrolithotomy complications using the modified Clavien grading system: looking for a standard
.
Eur Urol
.
2008
;
53
(
1
):
184
90
.
19.
de la Rosette
JJ
,
Zuazu
JR
,
Tsakiris
P
,
Elsakka
AM
,
Zudaire
JJ
,
Laguna
MP
, et al.
Prognostic factors and percutaneous nephrolithotomy morbidity: a multivariate analysis of a contemporary series using the Clavien classification
.
J Urol
.
2008
;
180
(
6
):
2489
93
.
20.
Turna
B
,
Umul
M
,
Demiryoguran
S
,
Altay
B
,
Nazli
O
.
How do increasing stone surface area and stone configuration affect overall outcome of percutaneous nephrolithotomy?
J Endourol
.
2007
;
21
(
1
):
34
43
.
21.
Thomas
K
,
Smith
NC
,
Hegarty
N
,
Glass
JM
.
The Guy’s stone score: grading the complexity of percutaneous nephrolithotomy procedures
.
Urology
.
2011
;
78
(
2
):
277
81
.
22.
Smith
A
,
Averch
TD
,
Shahrour
K
,
Opondo
D
,
Daels
FP
,
Labate
G
, et al.
A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy
.
J Urol
.
2013
;
190
(
1
):
149
56
.
23.
Okhunov
Z
,
Friedlander
JI
,
George
AK
,
Duty
BD
,
Moreira
DM
,
Srinivasan
AK
, et al.
S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi
.
Urology
.
2013
;
81
(
6
):
1154
9
.
24.
Michel
MS
,
Trojan
L
,
Rassweiler
JJ
.
Complications in percutaneous nephrolithotomy
.
Eur Urol
.
2007
;
51
(
4
):
899
906
.
25.
Labadie
K
,
Okhunov
Z
,
Akhavein
A
,
Moreira
DM
,
Moreno-Palacios
J
,
del Junco
M
, et al.
Evaluation and comparison of urolithiasis scoring systems used in percutaneous kidney stone surgery
.
J Urol
.
2015
;
193
(
1
):
154
9
.
26.
Tailly
TO
,
Okhunov
Z
,
Nadeau
BR
,
Huynh
MJ
,
Labadie
K
,
Akhavein
A
, et al.
Multicenter external validation and comparison of stone scoring systems in predicting outcomes after percutaneous nephrolithotomy
.
J Endourol
.
2016
;
30
(
5
):
594
601
.
27.
Aldaqadossi
HA
,
Khairy Salem
H
,
Kotb
Y
,
Hussein
HA
,
Shaker
H
,
Dikaios
N
.
Prediction of pediatric percutaneous nephrolithotomy outcomes using contemporary scoring systems
.
J Urol
.
2017
;
198
(
5
):
1146
52
.
28.
Ozgor
F
,
Yanaral
F
,
Savun
M
,
Ozdemir
H
,
Sarilar
O
,
Binbay
M
.
Comparison of STONE, CROES and Guy’s nephrolithometry scoring systems for predicting stone-free status and complication rates after percutaneous nephrolithotomy in obese patients
.
Urolithiasis
.
2018
;
46
(
5
):
471
7
.
29.
Sfoungaristos
S
,
Gofrit
ON
,
Pode
D
,
Landau
EH
,
Duvdevani
M
.
Percutaneous nephrolithotomy for staghorn stones: which nomogram can better predict postoperative outcomes?
World J Urol
.
2016
;
34
(
8
):
1163
8
.
30.
Yanaral
F
,
Ozgor
F
,
Savun
M
,
Sahan
M
,
Sarilar
O
,
Binbay
M
.
Comparison of CROES, S.T.O.N.E, and Guy’s scoring systems for the prediction of stone-free status and complication rates following percutaneous nephrolithotomy in patients with chronic kidney disease
.
Int Urol Nephrol
.
2017
;
49
(
9
):
1569
75
.
31.
Kocaaslan
R
,
Tepeler
A
,
Buldu
I
,
Tosun
M
,
Utangac
MM
,
Karakan
T
, et al.
Do the urolithiasis scoring systems predict the success of percutaneous nephrolithotomy in cases with anatomical abnormalities?
Urolithiasis
.
2017
;
45
(
3
):
305
10
.
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