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Okada T. et al., 2023: Quality of life after urinary stone surgery based on Japanese Wisconsin Stone Quality of Life questionnaire: multicenter analysis from SMART study group.

Okada T, Hamamoto S, Taguchi K, Okada S, Inoue T, Ando R, Okada A, Yasui T
Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
Department of Urology, Gyotoku General Hospital, Chiba, Japan.
Department of Urology, Hara Genitourinary Hospital, Hyogo, Japan.

Abstract

We aimed to evaluate the impact of surgical treatment for urinary stones on perioperative health-related quality of life (HRQOL) using the Japanese Wisconsin Stone Quality of Life questionnaire (J-WISQOL), an HRQOL measure designed for patients with urinary stones. This study prospectively enrolled 123 patients with urinary stones who visited three academic hospitals for stone treatment. The participants completed the J-WISQOL within 4 weeks before and after the urinary stone treatment. Treatments included shock wave lithotripsy (SWL), ureteroscopy lithotripsy, and endoscopic combined intrarenal surgery. J-WISQOL was assessed for age, stone size and location, type of treatment, stone-free status, postoperative ureteral stent placement, hospital stay, and complications in all patients. Patients with stones in the ureter had significantly greater social impact D1 and disease impact D3 than those with stones in the kidney. In a comparison of pre- and postoperative J-WISQOL, patients without postoperative ureteral stent placement scored significantly higher on social impact D1 and disease impact D3. Patients with shorter hospital stays had significantly higher social impact D1 and disease impact D3 (p < 0.001) than those with longer hospital stays. SWL significantly improved the total score, social impact D1, and disease impact D3 compared with other treatments. Perioperative HRQOL in patients with urinary stones is particularly affected by the type of treatment, ureteral stent placement, and hospital stay, which should be considered in surgical selection and patient decision-making.

SMART study group.Urolithiasis. 2023 Sep 14;51(1):113. doi: 10.1007/s00240-023-01486-8. PMID: 37707652

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Comments 1

Hans-Göran Tiselius on Thursday, 23 May 2024 11:00

Several recent reports have shown that evaluation of procedures for stone removal should include aspects on quality of life (QoL). Accordingly, the authors of this article have applied a Japanese version of the Wisconsin QoL questionnaire in a multicenter study. There are some interesting conclusions based on response from 127 patients of whom 35 were treated with SWL, 62 with URS and 26 with endoscopy combined with percutaneous surgery (ECIR). One important basic notation is that none of the patients treated with SWL had internal ureteral stents.
The stone-free rates after 4 weeks were 66% for SWL, 95% for URS and 85% for ECIR. Interestingly and not unexpectedly the social and disease impact was lower in patients with ureteral stones. Absence of internal stents resulted in significantly improved scores in patients without stents than in those with stents.

Particularly interesting is it to note that patients treated with SWL had significantly improved total score, social score, and disease score. The surprising finding was that patients treated with SWL improved their score even though this group had a lower stone-free rate!

The conclusion is that when methods for stone removal are evaluated and compared, it is important to add associated information on QoL.

Hans-Göran Tiselius

Several recent reports have shown that evaluation of procedures for stone removal should include aspects on quality of life (QoL). Accordingly, the authors of this article have applied a Japanese version of the Wisconsin QoL questionnaire in a multicenter study. There are some interesting conclusions based on response from 127 patients of whom 35 were treated with SWL, 62 with URS and 26 with endoscopy combined with percutaneous surgery (ECIR). One important basic notation is that none of the patients treated with SWL had internal ureteral stents. The stone-free rates after 4 weeks were 66% for SWL, 95% for URS and 85% for ECIR. Interestingly and not unexpectedly the social and disease impact was lower in patients with ureteral stones. Absence of internal stents resulted in significantly improved scores in patients without stents than in those with stents. Particularly interesting is it to note that patients treated with SWL had significantly improved total score, social score, and disease score. The surprising finding was that patients treated with SWL improved their score even though this group had a lower stone-free rate! The conclusion is that when methods for stone removal are evaluated and compared, it is important to add associated information on QoL. Hans-Göran Tiselius
Friday, 12 July 2024