Introduction: The objective of the research is to assess the clinical use of the Quadruple D scoring technique for estimating the stone-free rate (SFR after extracorporeal shock wave lithotripsy (SWL) of renal stones less than 2 cm in diameter.

Patients and Methods: 100 patients presented to the Minia Urology and Nephrology University Hospital SWL unit were studied. The skin to stone distance (SSD), stone density[HU], stone dimension (volume), and stone dispersion (distribution) are the four computed tomography-based parameters that make up the quadruple D scoring technique. The PiezoLith 3000Plus, a piezoelectric shockwave lithotripter, was used to conduct our investigation. Three weeks after the SWL session, SFR was assessed using the PUT.

Results: The study found that ,although age, gender, and stone laterality were not reliable predictors of SFR after SWL, stone size, stone density, stone distribution, patient BMI, and SSD were. The Quadruple-D score of the residual (n=29) group was significantly lower than that of the stone-free (n=71) group. Following the first SWL session, the Quadruple D score of 0, 1, 2, 3, and 4 points indicated SFRs of 0%, 0%, 46.15%, 84.21%, and 100%, respectively. The quadruple-D score is an important clinical assessment technique for predicting SFR after SWL .Regarding to stone location, most groups with residual stones had lower calyceal stones, showing a statistically significant difference.

Conclusion: The quadruple-D scoring system is an effective method for selecting the most qualified SWL candidates and a straightforward manual nomogram for predicting SFR after SWL.