Introduction: Ureteral stent-related pain varies in intensity for different patients. While stent-specific factors (e.g. stent position) may influence symptoms, patient-specific factors remain elusive. The pain catastrophizing scale (PCS) is a validated questionnaire quantifying the degree to which an individual may catastrophize painful stimuli. We aim to determine whether PCS score is associated with stent symptoms after ureteroscopic laser lithotripsy (URSLL). Methods: This is an ongoing prospective study of patients undergoing URSLL. All patients completed the PCS prior to undergoing URSLL with stent placement and were labeled as catastrophizers (top third), non-catastrophizers (bottom third), or semi-catastrophizers (middle third). The ureteral stent symptom questionnaire (USSQ) was completed at 2 time points: post-op day (POD)#1 and POD#10. Prescriptions for phenazopyridine, ibuprofen, and oxybutynin were given. Outcomes included USSQ scores, total analgesic pills taken, pain-related office phone calls, and need for narcotic prescriptions. Results: In sum 41 patients have been enrolled. Median USSQ pain scores on POD#10 were significantly higher among catastrophizers as compared to non-catastrophizers (24.5 vs. 14.0, p=0.036). There were no differences between all 3 groups in other USSQ domains. Catastrophizers took more tablets of phenazopyridine (11.0 vs. 5.5, p=0.027) and total prescribed tablets (26.5 vs. 15.5, p=0.023) compared to non-catastrophizers. Differences between number of pain-related calls between catastrophizers and non-catastrophizers approached significance (46.2% vs. 0%, p=0.057). Semi-catastrophizers had no significantly different outcomes from the other two groups. Conclusions: Pain catastrophizers have higher post-URSLL pain index scores, use more pain medications, and likely call the office more frequently. The PCS may ultimately become a practical tool to personalize patient care by identifying those at highest risk for severe stent pain. SOURCE OF Funding: None
