Presented by: Shuzo Hamamoto MD, PhD.
Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences

Introduction

Health-related quality of life (HRQOL) assesses the impact of health conditions and symptoms on daily life of stone formers. However, no study has yet compared the HRQOL pre- and post-operation for urinary stones and the factors associated with these changes by HRQOL. We evaluated the impact of surgical treatment for urinary stones on perioperative health-related quality of life (HRQOL) using the Japanese Wisconsin Stone Quality of Life questionnaire (J-WISQOL), an HRQOL measure designed for patients with urinary stones.

Materials

This study prospectively enrolled 123 patients with urinary stones who visited three academic hospitals for stone treatment. The participants completed the J-WISQOL within four weeks before and after the urinary stone treatment.Treatments included shock wave lithotripsy (SWL), ureteroscopy lithotripsy (URSL), and endoscopic combined intrarenal surgery (ECIRS). J-WISQOL was assessed for age, stone size and location, type of treatment, stone-free status, postoperative ureteral stent placement, hospital stay, and complications in all patients.

Results

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In the preoperative J-WISQOL, patients with stones in the ureter had significantly greater social impact D1 (p=0.005) and disease impact D3 (p=0.045) than those with stones in the kidney. In a comparison of pre- and postoperative J-WISQOL, patients without postoperative ureteral stent placement scored significantly higher social impact D1 (p=0.007) and disease impact D3 (p<0.001). Patients with less than the median length of hospital stay had significantly higher social impact D1 (p=0.001) and disease impact D3 (p<0.001) compared to those with longer hospital stay. SWL significantly improved the total score (p=0.015), social impact D1 (p=0.017), and disease impact D3 (p=0.004) compared with other treatments.

Conclusion

In this study, we evaluated, the pre- and postoperative changes in HRQOL of SWL, URSL, and ECIRS in patients with urinary stones using J-WISQOL. Perioperative HRQOL in patients with urinary stones is particularly affected by the type of treatment, ureteral stent placement, and hospital stay, which should be considered in surgical selection and patient decision-making. 

Funding

none

Co-Authors

Tomoki Okada, MD
Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences

Kazumi Taguchi, MD, PhD.
Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences

Shinsuke Okada, MD
Department of Urology, Gyotoku General Hospital

Takaaki Inoue, MD, PHD.
Department of Urology, Hara Genitourinary Hospital

Atsushi Okada, MD, PHD.
Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences

Takahiro Yasui, MD, PHD,
Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences