Mp19-01 stone location and stenting influence patient-reported pain and quality of life after ureteroscopy

You have accessJournal of UrologyCME1 Apr 2023MP19-01 STONE LOCATION AND STENTING INFLUENCE PATIENT-REPORTED PAIN AND QUALITY OF LIFE AFTER URETEROSCOPY Russell E. N. Becker, Stephanie Daignault-Newton, Andrew M. Higgins, Mahin Mirza, Bronson Conrado, Golena Fernandez Moncaleano, Mahmoud Hijazi, Karla Witzke, Jeremy Konheim, Richard Sarle, Kandis Rivers, William W. Roberts, Khurshid R. Ghani, Casey A. Dauw, and for the Michigan Urological Surgery Improvement Collaborative Russell E. N. BeckerRussell E. N. Becker More articles by this author , Stephanie Daignault-NewtonStephanie Daignault-Newton More articles by this author , Andrew M. HigginsAndrew M. Higgins More articles by this author , Mahin MirzaMahin Mirza More articles by this author , Bronson ConradoBronson Conrado More articles by this author , Golena Fernandez MoncaleanoGolena Fernandez Moncaleano More articles by this author , Mahmoud HijaziMahmoud Hijazi More articles by this author , Karla WitzkeKarla Witzke More articles by this author , Jeremy KonheimJeremy Konheim More articles by this author , Richard SarleRichard Sarle More articles by this author , Kandis RiversKandis Rivers More articles by this author , William W. RobertsWilliam W. Roberts More articles by this author , Khurshid R. GhaniKhurshid R. Ghani More articles by this author , Casey A. DauwCasey A. Dauw More articles by this author , and for the Michigan Urological Surgery Improvement Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003244.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Studies of ureteroscopy outcomes have historically centered on efficacy (stone-free rates) and safety (complications). However, the patient’s own subjective experience, including pain and health-related quality of life (HRQOL), are gaining recognition as additional important factors. Empirical data on these are severely lacking. We have previously reported that ureteral stent placement after ureteroscopy increases unplanned healthcare encounters. However, less is known about the impact of stent placement on HRQOL. METHODS: The Michigan Urological Surgery Improvement Collaborative (MUSIC) Reducing Operative Complications from Kidney Stones (ROCKS) group launched a patient-reported outcomes (PRO) program in 2021 which includes assessments of pain (PROMIS Pain Intensity and Pain Interference), lower urinary tract symptoms (LURN), and treatment satisfaction (ICIQ). This automated system distributes electronic questionnaires preoperatively and at 7-10 days and 4-6 weeks postoperatively. We compared postoperative day 7-10 (POD7) PROs for stented versus not stented patients based on stone location (renal versus ureteral) with linear regression models adjusting for preoperative score, age, gender, pre-stenting, and stone size. RESULTS: Clinical and PRO data were collected on 338 patients (64% ureteral, 36% renal stones). Overall 251 (74.3%) had a stent placed at the time of surgery. Stented patients had larger stones in both the ureteral (8 vs 6mm, p<0.001) and renal (10 vs 7mm, p<0.001) subgroups. Stent omission in patients with ureteral stones resulted in improved PROMIS Pain Interference (52.7 vs 57.4, p<0.01), PROMIS Pain Intensity (48.9 vs 53.6, p<0.01), LURN urinary symptoms (6.3 vs 10.3, p<0.001), and ICIQ treatment satisfaction (21.1 vs 18.5, p<0.01) at POD7 (Figure 1). For patients with renal stones, stent omission resulted in improved PROMIS Pain Interference (55.8 vs 61.1, p=0.02) and LURN urinary symptoms (6.9 vs 10.7, p<0.001), without significant differences in PROMIS Pain Intensity (52.9 vs 56.6, p=0.1) or ICIQ treatment satisfaction (20.0 vs 17.6, p=0.07). CONCLUSIONS: Stent omission at the time of ureteroscopy was associated with significantly better PROs at POD7 for patients with both ureteral and renal stones. Source of Funding: Blue Cross Blue Shield of Michigan © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e264 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Russell E. N. Becker More articles by this author Stephanie Daignault-Newton More articles by this author Andrew M. Higgins More articles by this author Mahin Mirza More articles by this author Bronson Conrado More articles by this author Golena Fernandez Moncaleano More articles by this author Mahmoud Hijazi More articles by this author Karla Witzke More articles by this author Jeremy Konheim More articles by this author Richard Sarle More articles by this author Kandis Rivers More articles by this author William W. Roberts More articles by this author Khurshid R. Ghani More articles by this author Casey A. Dauw More articles by this author for the Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement PDF downloadLoading ...