AUA 2018: Wisconsin Stone Quality of Life Questionnaire: Is Stone Removal Surgery Associated with Better Quality of Life?

San Francisco, CA USA ( Igor Sorokin, MD, a clinical urologist from UT Southwestern, presented his data on a validated questionnaire, the WISQOL (Wisconsin Stone Quality of Life), to assess the quality of life of patients with a history of nephrolithiasis. Dr. Sorokin and his team sought to compare the stone related quality of life (SR-QOL) of stone formers who had surgery within the last year to patients who never underwent surgery, as well as the SR-QOL associated with various surgical modalities. From 2014-2017, a multi-institutional prospective study was conducted across 5 stone clinics in North America.

The WISQOL survey was completed by adult stone-formers presenting in clinic. The patients were divided into 2 groups: patients who underwent stone-removal surgery within the last year and those who did not undergo surgery. WISQOL scores measuring social functioning, emotional functioning, disease or stone-related impact, and vitality were calculated. For participants who underwent surgery, patients were further sub-divided into groups based upon surgical modality and time of surgery (0-3.1 months and 3.1-12 months postoperative).

The results of this study revealed that for the group of patients within 3 months of surgery, SR-QOL was significantly lower than the no surgery group, specifically for patients who underwent SWL and URS but not PCNL. For the group of patients within 3.1-12 months of surgery, the mean SR-QOL score was higher than the no surgery group, but not statistically significant. Overall, emotional and disease domains showed closer return to baseline faster PCNL compared to ESWL and URS. The ability to focus on work, family, and interested improved after PCNL compared to other surgeries or no surgery. The pain experienced by patients was worst after ESWL compared to URS and PCNL. Diet adherence improved after URS and PCNL, but not after ESWL. Lastly, medication adherence improved after any surgical procedure compared to none.

In conclusion, the results of this study indicate that ESWL and URS are associated with lower SR-QOL scores within 3 months of surgery. Therefore, while ESWL and URS are considered less invasive procedures, efforts should be made to reduce the short-term morbidity.

After Dr. Sorokin gave his presentation, he was asked if his team considered pre-operative counseling as it may have affected how patients answered the questions post-operatively. Dr. Sorokin responded that the questionnaires were answered post-operatively, and pre-operative counseling was not included in the analysis of this study.

Presented by: Igor Sorokin, MD

Written by: Taylor Capretz, Department of Urology, University of California-Irvine at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA