University of Pennsylvania Perelman School of Medicine
Introduction: Nephrolithiasis is among the most common urological conditions. However, the impact of the disease on quality of life remains significantly understudied, particularly following surgical intervention. We prospectively captured patient-reported pain interference in patients following ureteroscopy (URS) or percutaneous nephrolithotomy (PCNL) for nephrolithiasis.
Methods: Adults undergoing URS or PCNL for renal/ureteral stones were eligible for inclusion (10/2020-10/2021). Patients prospectively completed PROMIS- Pain Interference instrument pre-operatively (POD 0) and via email on POD 1, 7, and 14. Scores are reported as T-scores (normalized to US pop., mean=50) with a change of 5 (0.5 SD) considered clinically significant. All post-operative ureteral stents and/or nephrostomy tubes were removed by POD 7.
Results: A total of 145 patients completed enrollment, 102 of which underwent URS and 43 of which underwent PCNL. For URS, there was an acute increase in pain interference between POD 0 and 1, but this recovered and even improved to below the baseline between POD 7 and 14 (repeated measures ANOVA; p <0.05) (Figure 1). For PCNL, there was a similar acute increase in pain interference between POD 0 and 1, but this was improved, although not completely recovered to the baseline even at POD 14 (repeated measures ANOVA; p<0.05) (Figure 2).
Conclusions: Pain interference on work, family, and social obligations increases immediately post-operatively for both patients undergoing URS and PCNL. However, there appears to be a relatively rapid recovery for patients undergoing URS between POD 7 and 14, but patients undergoing PCNL experience a less drastic recovery with continued pain interference, albeit minimal beyond POD 14. Results offer meaningful insights to assist in counseling patients prior to the surgical treatment of nephrolithiasis.