PD05-09 IMPROVED STONE QUALITY OF LIFE IN PATIENTS WITH OBSTRUCTING URETERAL STONE ON ALPHA-BLOCKER MEDICAL EXPULSIVE THERAPY

Abstract

You have accessJournal of UrologyCME1 May 2022PD05-09 IMPROVED STONE QUALITY OF LIFE IN PATIENTS WITH OBSTRUCTING URETERAL STONE ON ALPHA-BLOCKER MEDICAL EXPULSIVE THERAPY Brijesh Patel, Tarik Phillips, Joshua Palk, Joel Vetter, Mark Biebel, Alexander Chow, Alethea Paradis, Alana Desai, Kenneth Sands, and Ramakrishna Venkatesh Brijesh PatelBrijesh Patel More articles by this author , Tarik PhillipsTarik Phillips More articles by this author , Joshua PalkJoshua Palk More articles by this author , Joel VetterJoel Vetter More articles by this author , Mark BiebelMark Biebel More articles by this author , Alexander ChowAlexander Chow More articles by this author , Alethea ParadisAlethea Paradis More articles by this author , Alana DesaiAlana Desai More articles by this author , Kenneth SandsKenneth Sands More articles by this author , and Ramakrishna VenkateshRamakrishna Venkatesh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002524.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Though controversial, alpha blockers continue to be used widely for ureteral stone passage. However, its effects on the patient reported Quality of life (QOL), either positive, negative or no impact, is unknown. We compared the QoL of patients on alpha-blocker medical expulsive therapy (MET) to patients not on MET (noMET) utilizing a validated Wisconsin Stone Quality of Life (WISQOL). METHODS: After IRB approval, we performed a prospective study including patients on either MET or no MET after presenting to a tertiary-care ED with symptomatic, obstructing ureteral stones. Medical treatment type was decided at the point of care by the initial treating physician including medications for analgesia and nausea. Additionally, tamsulosin (0.4mg orally, daily) was prescribed for the MET group. The WISQOL survey was administered at baseline, 7-, 14-, 21- and 28-days following discharge from the ED or until stone expulsion. RESULTS: A total of 197 patients were enrolled, of which 116 (59.2%) completed questionnaires for analysis, 91 in the MET group and 25 in no MET. Average ureteral stone size was 4.7 (STD 1.8) mm and 3.1 (STD 1.0) mm for MET and no MET, respectively. Of completed surveys, 105 (90%) were completed at day 7, 67 (57.6%) at day 14, 53 (45.7%) at day 21, and 40 (34.5%) at day 28. Spontaneous stone passage occurred in 38 (41.8%) while on MET compared to the 7 (28.0%) in no MET (p = 0.21). In total, 8 (6.8%) patients returned to the ED for intractable pain and 11 (9.5%) required surgical intervention. MET was associated with an improved QoL scores across all WISQOL domains compared to no MET (Fig.1). Stone size, age, race, sex, comorbidity score and a prior stone history were not associated with risk of negative effect on QoL (Table 1). CONCLUSIONS: Use of alpha-blocker MET was associated with improved QOL on all WISQOL metrics compared to no MET patients. Larger, randomized controlled trial studies may validate these findings. Alpha-blocker treatment may be an indication to improve stone QOL in patients with ureteral stone colic. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e89 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Brijesh Patel More articles by this author Tarik Phillips More articles by this author Joshua Palk More articles by this author Joel Vetter More articles by this author Mark Biebel More articles by this author Alexander Chow More articles by this author Alethea Paradis More articles by this author Alana Desai More articles by this author Kenneth Sands More articles by this author Ramakrishna Venkatesh More articles by this author Expand All Advertisement PDF DownloadLoading ...