Introduction Urolithiasis is a common condition in urological practice, with a particularly high burden in the Middle East due to dietary and lifestyle factors. Effective evaluation and management require a systematic approach, yet trainees often struggle with decision-making due to patient- and stone-related variability. To address these challenges, we developed the selection, entry, lithotripsy, exit, and CT (SELECT) mnemonic and checklist, a structured five-tier systematic approach designed to streamline renal stone assessment and management. Methods A panel of endourologists and educators identified key challenges in urolithiasis management among urology residents. A pre-implementation survey was conducted among 28 residents in the Kuwait Board of Urology program to assess confidence and challenges in renal stone evaluation and keenness for a mnemonic. Following the development of the SELECT mnemonic and checklist, trainees were introduced to the tool and instructed to utilize it over four weeks. A post-implementation survey was then conducted, and feedback was collected from both trainees and training supervisors. Results Before implementation, only 25% of residents reported confidence in assessing renal stone characteristics and selecting treatment modalities. Post-implementation, 84% reported improved confidence in assessment, and 80% felt more assured in treatment selection. Supervisors also noted improved diagnostic accuracy and decision-making among trainees. The mnemonic reduced reliance on senior guidance, although time constraints were a reported limitation. Conclusion The SELECT mnemonic and checklist offer a structured, evidence-based approach to renal stone management, improving trainee confidence and decision-making. External validation and potential scoring integration could further enhance their utility in urological education and clinical practice.
Cureus. 2026 Jan 09*** epublish ***
Abdullatif E Al-Terki, Said Yaiesh, Rehan N Khan, Sharifah Maqames, Tariq F Al-Shaiji, Naser Al-Soudan Al-Anzi
Urology Unit, Department of Surgery, Amiri Hospital, Kuwait City, KWT., Urology Unit, Department of Surgery, Jaber Al Ahmad Hospital, Kuwait City, KWT., Kuwait Board of Urology, Kuwait Institute for Medical Specialization, Kuwait City, KWT.