MP43-02 PATIENTS ON MEDICAL EXPULSIVE THERAPY FOR OBSTRUCTING URETEROLITHIASIS - THE WISCONSIN STONE QUALITY OF LIFE (WISQOL) SURVEY

Abstract

You have accessJournal of UrologyStone Disease: Medical & Dietary Therapy (MP43)1 Apr 2020MP43-02 PATIENTS ON MEDICAL EXPULSIVE THERAPY FOR OBSTRUCTING URETEROLITHIASIS - THE WISCONSIN STONE QUALITY OF LIFE (WISQOL) SURVEY Tarik Phillips*, Alexander Chow, Alethea Paradis, Joel Vetter, and Ramakrishna Venkatesh Tarik Phillips*Tarik Phillips* More articles by this author , Alexander ChowAlexander Chow More articles by this author , Alethea ParadisAlethea Paradis More articles by this author , Joel VetterJoel Vetter More articles by this author , and Ramakrishna VenkateshRamakrishna Venkatesh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000898.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Medical expulsive therapy (MET) utilizing alpha- blockers is commonly prescribed by urologists and emergency department (ED) physicians, however, its efficacy in ameliorating ureteral stone passage is controversial. Hence, as is currently unknown, it is desirable to know the overall quality of life (QOL) of patients on MET. We evaluated the QOL of patients utilizing a validated patient reported stone specific questionnaire, Wisconsin Stone Quality of Life (WISQOL) METHODS: This is an IRB approved prospective study of 100 patients on MET who presented to a tertiary care ED with a symptomatic obstructing ureteral stone. MET consisted of one month of Tamsulosin (.4 mg PO daily) and additional medications for analgesia and emetic control as needed per recommendation of the prescribing physician. The WISQOL survey was administered at baseline, 7, 14, 21 and 28 days following discharge from the ED or until stone expulsion. RESULTS: 100 patients were enrolled, of which 47 completed questionnaires for analysis. Average ureteral stone size was 5.1(STD 1.4) mm. 38% reported having a history of stones. 39 (83%) completed the survey at day 7, and 23 (48.9%), 20 (40.6%), 12(25.5%) at days 14, 21, 28 respectively. 13 (27.7%) reported spontaneous stone passage while on MET. Two (4.3%) patients returned to the ED for intractable pain and 5 (11.1%) required surgical intervention. Compared to baseline, there was no change in WISQOL domains including social impact, emotional impact, disease impact or overall score while on MET at 7 days. Those who remain on MET at 14 days reported a significantly negative impact on all QOL domains including social (p = 0.01), emotional (p < 0.01), disease (p = 0.04), vitality (p = 0.03), and overall score (p < 0.01). In completed subsequent surveys, negative QOL impact persisted up to 28 days [Figure 1]. Stone size, age, race, sex and a prior stone history were not associated with risk of negative effect on QOL. CONCLUSIONS: Patients remaining on MET at two weeks and beyond reported a negative impact on social, emotional and vitality QOL on the WISQOL survey. Identifying factors related to the poor QOL in patients on MET, may help in use of MET in select patients and counseling about the adverse effects of MET. Surgical intervention if stone fails to pass at two weeks may need to be considered. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e647-e647 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tarik Phillips* More articles by this author Alexander Chow More articles by this author Alethea Paradis More articles by this author Joel Vetter More articles by this author Ramakrishna Venkatesh More articles by this author Expand All Advertisement PDF downloadLoading ...