University of Pennsylvania Perelman School of Medicine
Introduction: Urolithiasis is among the most common urological conditions, however, the quality-of-life impact of stone disease remains significantly understudied, particularly following surgical intervention. We prospectively captured patient-reported outcomes related to pain interference and social participation in the short term post-operative period to better understand the quality-of-life impact of ureteroscopy (URS). Methods: Adults undergoing URS for renal/ureteral stones were eligible for inclusion (10/2020-09/2022). Two instruments were used to evaluate social participation and pain interference. Patients prospectively completed PROMIS Ability to participate in social roles and activities and Pain Interference instruments pre-operatively (POD 0) and via email on POD 1, 7, 14 and 30. Scores are reported as T-scores with a change of 5 (0.5 SD) considered clinically significant. Results: 178 patients completed enrollment at POD 0 (POD 1=87, POD 7=83, POD 14=70, POD30=67). There were statistically significant differences in pain interference and social participation scores between all-time point comparisons (Figure 1 and 2, all p<0.05). Higher BMI was associated with both lower baseline social participation (OR -0.46; CI: -0.71- -0.20, P<0.01) and greater baseline pain interference (OR 0.52; CI: 0.22-0.81, P<0.01). Pre-operative stent is associated with greater baseline pain interference (OR 7.1; CI: 2.3–12; p=0.004). Having a stent post-operatively is associated with higher pain interference (OR 24; CI: 0.66-48, P<0.04) and lower social participation (OR -38; CI: -64--11; p<0.01) on POD 7. Conclusions: Ability to participate in social roles and activities declines immediately post-operatively, while pain interference sharply increases. However, patients return to baseline social participation and see resolution of pain interference by POD 14. Findings suggest both pre-operative and post-operative stents may be impacting patients’ quality of life. SOURCE OF Funding: NA
