Determinants of health-related quality of life for patients after urinary lithotripsy: ureteroscopic vs. shock wave lithotripsy
To compare the longitudinal health-related quality of life (HRQoL) after surgical intervention with ureteroscopic lithotripsy (URSL) and shock wave lithotripsy (SWL) and to evaluate the factors affecting HRQoL in urolithiasis patients.
A total of 262 patients who underwent lithotripsy (SWL, n = 61; URSL, n = 201) for upper urinary tract calculi treatment between June 2012 and January 2015 were evaluated. All patients were administered the Short-Form 36-item survey (SF-36) to assess HRQoL at four timepoints: before surgery, on the day of discharge, and 1 and 6 months after lithotripsy. Stone-free rates, complications, and analgesic requirements were evaluated to compare the effects of the two procedures on HRQoL.
At the day of discharge, patients in the URSL group had significantly lower mean scores on five different subscales of the SF-36 questionnaire, namely, physical functioning, role-physical, social functioning, role-emotional, and mental health. The stone-free rate at 3 months after lithotripsy was significantly lower in the SWL group (72.1% vs. URSL, 93.0%; p < 0.001). The hospital stay was shorter in the SWL group (2.1 ± 0.07 vs. URSL, 4.1 ± 0.13 days; p < 0.001), and the analgesia requirements were also lower in the SWL group (0.3 ± 0.08 vs. URSL, 0.9 ± 0.20; p < 0.001).
The post-lithotripsy HRQoL was superior for SWL compared to URSL on the discharge date despite the lower stone-free rate of the former. The longer hospital stay and higher postoperative pain appeared to be the determinants of the lower HRQoL in the URSL group.
KeywordsHealth-related quality of life Ureteroscopic lithotripsy Shock wave lithotripsy The Short-Form 36-item survey Analgesia requirements
Health-related quality of life
Shock wave lithotripsy
Role component score
Physical component score
Mental component score
European Association of Urology
American Urological Association
Role limitation because of physical health
Role limitation because of emotional problems
We would like to thank Ms. K. Ichikawa and Ms. M. Noda for secretarial assistance, including their contribution in data input and analysis.
Compliance with ethical standards
Conflict of interest
The authors have no conflicts of interest to declare.
- 21.Gerber GS, Brendler CB (2007) Evaluation of the urologic patient: history, physical examination, and urinalysis. In: Campbell-Walsh Urology, 9th edn. Saunders Elsevier, Philadelphia, pp 81–110Google Scholar