MP38-08 DETERMINANTS OF HEALTH-RELATED QUALITY OF LIFE FOR PATIENTS AFTER URINARY LITHOTRIPSY: URETEROSCOPIC VERSUS SHOCK WAVE LITHOTRIPSY

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You have accessJournal of UrologyStone Disease: Surgical Therapy IV1 Apr 2015MP38-08 DETERMINANTS OF HEALTH-RELATED QUALITY OF LIFE FOR PATIENTS AFTER URINARY LITHOTRIPSY: URETEROSCOPIC VERSUS SHOCK WAVE LITHOTRIPSY Shuzo Hamamoto, Takahiro Yasui, Naoko Okuda, Satoshi Koiwa, Atsushi Okada, Hiroyuki Kamiya, Yoshihiro Hashimoto, Keiichi Tozawa, Yutaka Iwase, and Kenjiro Kohri Shuzo HamamotoShuzo Hamamoto More articles by this author , Takahiro YasuiTakahiro Yasui More articles by this author , Naoko OkudaNaoko Okuda More articles by this author , Satoshi KoiwaSatoshi Koiwa More articles by this author , Atsushi OkadaAtsushi Okada More articles by this author , Hiroyuki KamiyaHiroyuki Kamiya More articles by this author , Yoshihiro HashimotoYoshihiro Hashimoto More articles by this author , Keiichi TozawaKeiichi Tozawa More articles by this author , Yutaka IwaseYutaka Iwase More articles by this author , and Kenjiro KohriKenjiro Kohri More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1383AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Shock wave lithotripsy (SWL) and ureteroscopic lithotripsy (URSL) are well-established procedures for fragmentation of stones using a lithotripter; however, the morbidity, hospitalization, and days lost from daily work can negatively affect the health-related quality of life (HRQoL) of patients. Recently, there has been increasing recognition that the selection of therapeutic modality for urinary lithotripsy should be based not only on the stone free rate, but also on the future HRQoL. Thus, we here aimed to compare longitudinal HRQoL between SWL and URSL patients after surgical intervention, and to evaluate the factors affecting the HRQoL of these patients. METHODS In this institutional review board-approved study we prospectively interviewed 262 consecutive patients who underwent SWL (n=61) or URSL (n=201) for treatment of upper urinary tract calculi between June 2012 and October 2013. All patients were prospectively administered the Short-Form 36-item survey (SF-36) to assess the HRQoL at discharge, 1 month, and 6 months after lithotripsy. The stone-free rate, hospital stay, complications, and analgesia requirements were evaluated to compare the effects of surgery on the HRQoL between the groups. RESULTS At the day of discharge, patients in the URSL group had significantly lower mean scores on 6 different subscales of the SF-36 questionnaire, namely physical functioning, role-physical, body pain, social functioning, role-emotional, and mental health. The stone-free rate at 3 months after lithotripsy was significantly lower in the SWL group (72.1% vs. URSL, 93.0%; p<0.01). The hospital stay was shorter in the SWL group (2.1 ± 0.07 vs. URSL, 4.1 ± 0.13 days; p<0.001), and the analgesia requirements were also lower in the SWL group (0.3 ± 0.08 vs. URSL, 0.9 ± 0.20; p<0.001). The multivariate analyses identified several variables that were significantly associated with the low HRQoL after lithrotripsy, including age (p=0.04) and the use of analgesic agents. CONCLUSIONS The post-lithotripsy HRQoL is better for SWL than URSL patients, despite the lower stone-free rate of SWL. The higher postoperative pain appear to be responsible for the lower HRQoL in URSL. For the appropriate decision regarding the treatment approach, it is important to understand not only the surgical outcomes and recurrence rates, but also the HRQoL associated with each treatment strategy. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e449 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shuzo Hamamoto More articles by this author Takahiro Yasui More articles by this author Naoko Okuda More articles by this author Satoshi Koiwa More articles by this author Atsushi Okada More articles by this author Hiroyuki Kamiya More articles by this author Yoshihiro Hashimoto More articles by this author Keiichi Tozawa More articles by this author Yutaka Iwase More articles by this author Kenjiro Kohri More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...