Is Stone-Free Status After Surgical Intervention for Kidney Stones Associated with Better Health-Related Quality of Life? - A Multicenter Study from the North American Stone Quality of Life Consortium.

To compare the health-related quality of life (HRQOL) of patients with residual fragments after surgical intervention for kidney stones to patients that are stone-free using the disease-specific WISQOL questionnaire.

Kidney stones contribute to impaired HRQOL, which is increasingly recognized as an important healthcare outcome measurement.

With IRB approval, 313 adult patients who underwent surgical intervention for kidney stones at 4 sites completed a WISQOL questionnaire. We retrospectively collected surgical data including presence of residual fragments on post-operative imaging. We calculated standardized WISQOL total and domain scores (0-100), which included items related to social functioning (D1), emotional functioning (D2), stone-related impact (D3) and vitality (D4). Scores were compared between patients with residual fragments to those who were stone-free after surgical intervention.

Demographics did not differ between groups, overall mean age 54.6 ± 13.5 and 55.4% female. There was no significant difference in total WISQOL score for patients with residual fragments (n=124) compared to patients that were stone-free (n=189), 110.5 ± 27.8 vs 115.4 ± 23.6 respectively, (p=0.12). Interestingly, patients with residual fragments who underwent secondary surgery were found to have significantly lower total WISQOL score (88.4 ± 30.1 vs 116.6 ± 25.0, p<0.0001).

Stone-free status after surgical intervention is not associated with better HRQOL when compared with patients whose surgeries left residual fragments. Indeed, further surgical intervention on residual fragments to achieve stone-free status may actually result in worse HRQOL.

Urology. 2020 Dec 05 [Epub ahead of print]

Necole M Streeper, Matthew Galida, Suzanne Boltz, Shuang Li, Stephen Y Nakada, Eric P Raffin, David R Brown, Vernon M Pais, Justin Yh Chan, Kymora B Scotland, Ben H Chew, Kristina L Penniston

Division of Urology, Penn State Milton S. Hershey Medical Center; Hershey, PA. Electronic address: ., Division of Urology, Penn State Milton S. Hershey Medical Center; Hershey, PA., Department of Urology, University of Wisconsin School of Medicine and Public Health; Madison, WI., Department of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH., Department of Urologic Sciences, University of British Columbia; Vancouver, British Columbia, Canada.

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