Evaluating Parameters Affecting Fluoroscopy Time During Percutaneous Nephrolithotomy: Focus on the Predictive Role of Guy's, S.T.O.N.E., and CROES Scoring Systems

To identify parameters predicting prolonged fluoroscopy time (FT) during percutaneous nephrolithotomy (PCNL) and to evaluate the predictive ability of Guy's stone score, S.T.O.N.E. nephrolithometry, and CROES nomogram. We evaluated 153 consecutive patients who underwent a PCNL by a single experienced surgeon. Several preoperative, intraoperative, and postoperative parameters, including the three scoring systems, were assessed for their ability to predict FT. FT was significantly associated with stone burden, stone location, number of stones, number of punctures, and number of tracts. It was also significantly associated with all scoring systems. Fluoroscopy use was significantly higher in patients who were effectively treated in these with longer hospitalization, probably reflecting case complexity. No association was found with postoperative complications. FT during PCNL can be affected by several parameters. Identifying the ones that can affect FT can lead to fluoroscopy and radiation exposure decrease. Guy's stone score, S.T.O.N.E. nephrolithometry, and CROES nomogram can all predict complexed cases and the need for increased FT.