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Sahin C et al, 2015: Stone size and quality of life: A critical evaluation after extracorporeal shock wave lithotripsy.

Sahin C, Cetinel AC, Eryildirim B, Tuncer M, Faydaci G, Sarica K.
Dr. Lutfi Kirdar Training and Research Hospital, Departments of Urology, Istanbul.

Abstract:

OBJECTIVES: To evaluate the quality of life (QoL) of the patients after extracorporeal shockwave lithotripsy (ESWL) on a treated stone size related basis.

METHODS: 90 patients undergoing ESWL for kidney stones were divided into three groups; Group 1 (n: 30, ≤ 10 mm), Group 2 (n: 28, 11 mm- ≤ 20 mm) and Group 3 (n: 32, 20- 25 mm). During 3- months follow-up, outcome of the procedure, number of cases with emergency department visits, analgesic required, re-tretatment rates, additional procedures and the changes in the QoL were evaluated.

RESULTS: the number of emergency department visits and mean analgesic need; re-treatment rates and additional procedures were significantly higher in Group 3. Evaluation of the QoL scores in three groups showed that cases with larger stone still had lower scores during 3-month evaluation.

CONCLUSIONS: Stone size could help us to predict the possible impact of ESWL on the QoL and depending on the size of the stone treated, a well planned indication and effective management possibly by an experienced urologist could limit the changes in the QoL of the patients. “...the absence of significant changes in SF-36 scores despite changes in stone status suggests that the SF-36 may not be an adequate tool to monitor QoL in stone patients. Validated, disease specific QoL tools are needed for comparison of treatment strategies in stone disease.

Arch Ital Urol Androl. 2015 Sep 30;87(3):227-32. doi: 10.4081/aiua.2015.3.227.

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Comments 1

Peter Alken on Monday, 11 April 2016 12:48

Despite all the improvement in stone therapy our knowledge about patient satisfaction, preference and quality of life is scarce. It is a surprise and difficult to understand that in the present study despite a successful therapy the different domains of the SF-36 used did not improve above the values which were recorded before shock wave lithotripsy. The following quote from Donally C J et al. (Longitudinal evaluation of the SF-36 quality of life questionnaire in patients with kidney stones Urol Res (2011) 39:141–146) “… the absence of significant changes in SF-36 scores despite changes in stone status suggests that the SF-36 may not be an adequate tool to monitor QoL in stone patients. Validated, disease specific QoL tools are needed for comparison of treatment strategies in stone disease.” is an important comment to be made to the present paper. So far the only urolithiasis specific instrument to evaluate QoL of stone patients was described by Penniston K L and Nakada S Y (Development of an Instrument to Assess the Health Related Quality of Life of Kidney Stone Formers. J Urol Vol. 189, 921-930, March 2013). Its further development is awaited.

Despite all the improvement in stone therapy our knowledge about patient satisfaction, preference and quality of life is scarce. It is a surprise and difficult to understand that in the present study despite a successful therapy the different domains of the SF-36 used did not improve above the values which were recorded before shock wave lithotripsy. The following quote from Donally C J et al. (Longitudinal evaluation of the SF-36 quality of life questionnaire in patients with kidney stones Urol Res (2011) 39:141–146) “… the absence of significant changes in SF-36 scores despite changes in stone status suggests that the SF-36 may not be an adequate tool to monitor QoL in stone patients. Validated, disease specific QoL tools are needed for comparison of treatment strategies in stone disease.” is an important comment to be made to the present paper. So far the only urolithiasis specific instrument to evaluate QoL of stone patients was described by Penniston K L and Nakada S Y (Development of an Instrument to Assess the Health Related Quality of Life of Kidney Stone Formers. J Urol Vol. 189, 921-930, March 2013). Its further development is awaited.
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