Introduction

The aim of this study was to compare the longitudinal health-related quality of life (HRQoL) at 4 time points between patients undergoing ureteroscopic lithotripsy (URSL) and patients undergoing shock wave lithotripsy (SWL). We also aimed to evaluate the factors that significantly affect the HRQoL in patients with urolithiasis.

Methods

We evaluated a total of 262 patients who underwent lithotripsy (SWL, n = 61; URSL, n = 201) for upper urinary tract calculi treatment between June 2012 and January 2015. All patients were administered the Short-Form 36-item survey (SF-36) to assess HRQoL at 4 time points: prior to surgery, on the day of discharge, and 1 and 6 months after lithotripsy. We evaluated stone-free rates, the occurrence of complications, and analgesic requirements in order to compare the effects of SWL versus URSL on HRQoL.

Results

On the day of discharge, patients in the URSL group had significantly lower average scores on the SF-36 survey in 5 different domains (physical function, role physical, social functioning, role emotional, and mental health) and in 1 summary scale (role component score [RCS]) than the SWL group. The stone-free rate at 3 months after lithotripsy was significantly lower in the SWL group than in the URSL group (72.1% vs. 93.0%; p < 0.001). Moreover, the analgesic requirements were lower in the SWL group than in the URSL group (0.3 ± 0.08 vs. 0.9 ± 0.20; p < 0.001). Multivariate analysis identified age and analgesic requirements as predictors of lower HRQoL on the RCS summary scale (p=0.029 and p=0.002, respectively).

Conclusions

Patients who underwent SWL had a higher post-lithotripsy HRQoL, but lower stone-free rates, compared to those who underwent URSL. Higher postoperative pain appeared to be the primary cause of the lower HRQoL in the URSL group. In order to determine the appropriate treatment approach, it is essential to understand not only the surgical outcomes and recurrence rates but also the HRQoL associated with each treatment strategy.

Funding

none