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Kidney Stone Calculator

STONE scoring system for percutaneous nephrolithotomy success prediction

STONE Scoring Parameters

Calculated as stone length × width on CT scan. Points: 0-399 mm² (0 pts), 400-799 mm² (1 pt), 800-1599 mm² (2 pts), ≥1600 mm² (3 pts)

Current points: 0

Distance from stone center to skin on CT. Points: ≤100 mm (0 pts), >100 mm (1 pt)

Current points: 0

Presence and severity of hydronephrosis. Points: No/mild (0 pts), Moderate/severe (1 pt)

Current points: 0

Number of kidney calyces containing stones. Points: 1-2 (0 pts), 3 (1 pt), Staghorn (2 pts)

Current points: 0

Stone density measured in Hounsfield units (HU) on CT. Points: ≤950 HU (0 pts), >950 HU (1 pt)

Current points: 0

STONE Score Results

0
Total STONE Score
(Range: 0-12 points)
98.8%
Success Probability
Stone-free after first PCNL
Risk Category:Low Risk

Excellent success rate

Score Breakdown:

Stone size: 0 pts
Tract length: 0 pts
Obstruction: 0 pts
Number of calyces: 0 pts
Stone density: 0 pts
Total: 0 pts

Clinical Interpretation

Example Case

Complex Kidney Stone Case

Stone size: 25mm × 20mm = 500 mm² (1 point)

Tract length: 120 mm (1 point)

Hydronephrosis: Moderate (1 point)

Calyces affected: 3 calyces (1 point)

Stone density: 1200 HU (1 point)

STONE Score Calculation

Total Score: 1 + 1 + 1 + 1 + 1 = 5 points

Success Probability: 93.6%

Risk Category: Low-Moderate Risk

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STONE Mnemonic

S

Stone Size

Length × Width (mm²)

0-3 points

T

Tract Length

Skin to stone distance

0-1 points

O

Obstruction

Hydronephrosis severity

0-1 points

N

Number

Calyces with calculi

0-2 points

E

Essence

Stone density (HU)

0-1 points

PCNL Tips

CT scan required for accurate measurements

Lower scores indicate higher success rates

Consider patient comorbidities

Alternative treatments for high-risk cases

Understanding the STONE Scoring System

What is PCNL?

Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure to remove large kidney stones (>1.5 cm) or complex stones that cannot be treated with other methods. The procedure involves creating a small incision in the back to access the kidney directly.

Why Use STONE Score?

  • Predicts stone-free outcome after first PCNL
  • Helps with treatment planning and patient counseling
  • Identifies cases requiring alternative approaches
  • Evidence-based risk stratification

PCNL Procedure Steps

1. Access Creation

Percutaneous tract from skin to kidney

2. Stone Fragmentation

Ultrasonic or laser lithotripsy

3. Fragment Removal

Suction and extraction of stone pieces

4. Nephrostomy

Temporary tube placement for drainage

⚠️ Medical Disclaimer

This calculator is for educational purposes only and should not replace professional medical advice. The STONE score is a predictive tool that helps estimate success probability but does not guarantee outcomes. Always consult with a qualified urologist for treatment decisions. Patient factors, surgeon experience, and institutional factors may influence actual outcomes.

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