Abstract
Introduction. In modern scientific literature it is becoming increasingly popular to study Quality of Life (QoL) index as an integral indicator of the entire therapeutic complex. QoL along with physical examination, laboratory and instrumental tests allows a doctor to fully assess patient’s condition. That is why the QoL researches has been recently become more and more widespread in the scientific papers. Aim. The aim of this study was to determine applicability of the Wisconsin Stone Quality of Life Questionnaire (WISQOL) and the SF-36 General Questionnaire for evaluating treatment outcomes and postoperative follow-up in patients with ureterolithiasis. Materials and methods. 123 patients with diagnosed urolithiasis (ureteral stone) were included in the study. Clinical efficacy of the shock wave lithotripsy (SWL) and contact (laser) ureterolithotripsy (CLT) was assessed after 1 week, 1 and 3 months using stone free rate (SFR). To analyze clinical factors influencing patients QoL, differences in the WISQOL and SF-36 total scores and scores before and after treatment were compared. At the third step, the dynamics of QoL indicators at different stages of treatment was analyzed. Results. The SFR at 1 week, 1 and 3 months after SWL and CLT were 47,1%, 58,8%, 72,5% and 6,4%, 84,7, 93,1% respectively. Gender, age, stone size and the Stone Free Rate achieved during treatment had a significant effect on QoL (p <0.05), while localization and density of a stone showed no effect. According to the WISQOL and SF-36 questionnaire, 1 week after CLT patients had lower levels of QoL, than after SWL (p < 0.05), but after 1 month the QoL for SWL and CLT reached the same levels and by 3 months became submaximal. Conclusions. Despite the higher rates of clinical efficacy, CLT showed lower QoL levels in the early postoperative period. Male sex, age up to 40 years, stone size more than 7 mm, and not achieved SFR during treatment contribute to lower QoL. To assess the dynamics of QoL levels in patients with ureterolithiasis, it is advisable to use the WISQOL.
Highlights
4.4 Calcium oxalate stones4.4.2 Interpretation of results and aetiology4.4.3 Specific treatment4.4.4 Recommendations for pharmacological treatment of patients with specific abnormalities in urine composition4.5 Calcium phosphate stones4.5.2 Interpretation of results and aetiology4.5.3 Pharmacological therapy4.5.4 Recommendations for the treatment of calcium phosphate stones4.6 Disorders and diseases related to calcium stones4.6.2 Granulomatous diseases4.6.3 Primary hyperoxaluria
In all patients undergoing endourologic treatment, perioperative antibiotic prophylaxis is recommended
A contrast study is recommended if stone removal is planned and the anatomy of the renal collecting system needs to be assessed
Summary
4.4 Calcium oxalate stones4.4.2 Interpretation of results and aetiology4.4.3 Specific treatment4.4.4 Recommendations for pharmacological treatment of patients with specific abnormalities in urine composition4.5 Calcium phosphate stones4.5.2 Interpretation of results and aetiology4.5.3 Pharmacological therapy4.5.4 Recommendations for the treatment of calcium phosphate stones4.6 Disorders and diseases related to calcium stones4.6.2 Granulomatous diseases4.6.3 Primary hyperoxaluria. 4.5.4 Recommendations for the treatment of calcium phosphate stones. 4.6 Disorders and diseases related to calcium stones. The European Association of Urology (EAU) Urolithiasis Guidelines Panel have prepared these guidelines to help urologists assess evidence-based management of stones/calculi and incorporate recommendations into clinical practice. The document covers most aspects of the disease, which is still a cause of significant morbidity despite technological and scientific advances. The EAU Urolithiasis Guidelines Panel consists of an international group of clinicians with particular expertise in this area. The recurrence risk is basically determined by the disease or disorder causing the stone formation. In countries with a high standard of life such as Sweden, Canada or the US, renal stone prevalence is noteably high (> 10%). Table 3.1.1: Prevalence and incidence of urolithiasis from two European countries [6, 7]
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