You have accessJournal of UrologyCME1 Apr 2023PD34-04 PREDICTIVE MODELS FOR SEVERE PAIN AND URINARY SYMPTOMS AFTER URETEROSCOPY WITH URETERAL STENT PLACEMENT FROM THE USDRN STENTS STUDY Gregory Tasian, Hongqiu Yang, Hussein Al-Khalidi, Michele Curatolo, Naim Maalouf, Jodi Antonelli, Alana Desai, Henry Lai, Peter Reese, Hunter Wessells, Justin Ziemba, Ziya Kirkali, Charles Scales, and Jonathan Harper Gregory TasianGregory Tasian More articles by this author , Hongqiu YangHongqiu Yang More articles by this author , Hussein Al-KhalidiHussein Al-Khalidi More articles by this author , Michele CuratoloMichele Curatolo More articles by this author , Naim MaaloufNaim Maalouf More articles by this author , Jodi AntonelliJodi Antonelli More articles by this author , Alana DesaiAlana Desai More articles by this author , Henry LaiHenry Lai More articles by this author , Peter ReesePeter Reese More articles by this author , Hunter WessellsHunter Wessells More articles by this author , Justin ZiembaJustin Ziemba More articles by this author , Ziya KirkaliZiya Kirkali More articles by this author , Charles ScalesCharles Scales More articles by this author , and Jonathan HarperJonathan Harper More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003327.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In order to identify patients most likely to benefit from strategies to improve post-operative experiences, the Urinary Stone Disease Research Network developed models to predict severe pain and urinary symptoms after ureteroscopy (URS) for urinary stones. METHODS: The cohort included participants who underwent URS with ureteral stent placement for ureteral and/or kidney stones at 4 centers in the United States as part of the prospective STENTS study. We fit multivariable logistic regression models with generalized estimating equations for three outcomes: severe pain intensity (i.e., magnitude of pain), pain interference (i.e., pain disrupting daily activities), and urinary symptoms. Each outcome was defined as the top quartile of symptoms reported on post-operative days 1, 3, 5, and 7 after URS. In the model building process, we tested the following variables that were all measured before URS and stent placement: age, sex, BMI, number of body regions affected by pain, current depression, ureteral stone location, prior URS, opioid use, hypersensitivity to mechanical pain (pressure pain threshold), and pain facilitation (temporal summation). RESULTS: The study included 424 participants, of whom 6.6% were adolescents, 93.4% were adults, and 47% were female. Two-hundred twelve participants (50%) had kidney stones and 203 (48%) had ureteral stones as the indication for URS. Models that included sex, number of body regions affected by pain, and depression successfully predicted all three outcomes (Figure). CONCLUSIONS: Pre-operative patient characteristics, particularly sex and psychosocial health, have good performance for predicting individuals who will experience severe pain and severe urinary symptoms after URS with ureteral stent placement. If validated in external cohorts, these models could be integrated into bedside practice to implement individualized pre-emptive strategies to improve post-surgical outcomes. Source of Funding: NIH/NIDDK © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e921 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gregory Tasian More articles by this author Hongqiu Yang More articles by this author Hussein Al-Khalidi More articles by this author Michele Curatolo More articles by this author Naim Maalouf More articles by this author Jodi Antonelli More articles by this author Alana Desai More articles by this author Henry Lai More articles by this author Peter Reese More articles by this author Hunter Wessells More articles by this author Justin Ziemba More articles by this author Ziya Kirkali More articles by this author Charles Scales More articles by this author Jonathan Harper More articles by this author Expand All Advertisement PDF downloadLoading ...
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