Category: Clinical Stones: Outcomes
Introduction & Objective : Renal and ureteral stones are assumed to be clinically significantly different, from clinician perspective. However it is unclear how different is their impact on patient’s health related quality of life (HRQoL). We evaluated this using the prospective data from the validation studies of the newly validated USIQoL (urinary stones and intervention quality of life) universal PROM tool
Consecutive adult patients with urinary (renal and ureteral) stones, attending the urology department at the four university hospitals were asked to complete the USIQoL questionnaire during the validation studies over 3 months. Patients completing the USIQoL, covering 5 domains were considered for final analyses. Individual domain scores, based on the USIQoL logit scores were calculated for the renal and ureteral stone groups. Similar data from the existing generic questionnaires was also collected. The data was compared, for the two groups, using the unpaired t test and ANOVA, for differences across the domain scores.
Of the 190 patients, 175 patients completed the study with the mean age of 49 years (range 18-90) with male predominance (63%). There were 116 patients with renal and 59 patients with ureteral stones. The results identified negative QoL impact affecting all domains of the USIQoL, for both stone groups. Ureteral stone patients had slightly higher pain (renal- 45, ureteral 48 p=0.2)) physical (R=57, U=61 p=0.1) and acute work impact scores (R=48, U=54 p= 0.08) while renal patients had slightly higher social (R=49, U=48, p=0.8), and similar psychological impact. None of the differences were significant, implying patients across both groups perceive the QoL impact similarly and considering them as a singular disease process.
For the first time, and contrary to many clinicians’ perceptions, patients' views imply similar Qol impact across different domains, for the renal and ureteral stones. This suggests that both groups need similar counselling approach, treatment evaluations and common QoL assessments justifying the development of a universal PROM approach.
Hrishi Joshi– Consultant Urological Surgeon and Honorary Lecturer, University Hospitla of Wales and Cardiff University, Cardiff, Wales, United Kingdom
Tim Pickles– Statistician, School of Medicine, Cardiff, cardiff, Wales, United Kingdom
Aditya Raja– Specialist Registrar, St. james's University Hospital, Leeds, England, United Kingdom
Shekhar Biyani– Consultant Urological Surgeon and Hon. sr. Lecturer, St. james's University Hospital NHS trust, Leeds, England, United Kingdom
Bhaskar Somani– Consultant Urologist, Associate Professor, University Hospital Southampton , U.K, Southampton, England, United Kingdom
Stefanos Bolomytis– Locum Consultant Urological Surgeon , Bristol Urological Institute, North Bristol NHS TRUST, Bristol, England, United Kingdom
Joe Philip– Consultant Urologist, North Bristol NHS Hospital NHS trust, Bristol, England, United Kingdom
Consultant Urological Surgeon and Honorary Lecturer
University Hospitla of Wales and Cardiff University
Cardiff, Wales, United Kingdom
St. james's University Hospital
Leeds, England, United Kingdom
Consultant Urological Surgeon and Hon. sr. Lecturer
St. james's University Hospital NHS trust
Leeds, England, United Kingdom
Consultant Urologist, Associate Professor
University Hospital Southampton , U.K
Southampton, England, United Kingdom
Bhaskar is an Endourologist and Associate Professor in Southampton, and is an active member of European School of Urology 'Training and Research group' and ESUT Endourology group. He has been teaching on EUREP hands-on-training for the last 5 years and is the senior author in the new ‘Endoscopic stone treatment (EST)’ curriculum established for training and examinations. He has performed live surgery in EAU with presentations and moderations in EULIS, WCE and SIU. He is also a member of EAU ‘Train the Trainer’ committee.
He is research active and has published more than 200 papers with over 300 published abstracts/presentations. He is on the editorial board of 3 journals, a reviewer for 14 journals and Investigator for 5 trials. He sits on the MCQ panel for FRCS examinations and is a ‘Specialist advisor’ to National Institute of Clinical Excellence (NICE) Interventional procedures and ‘Invited expert’ to NICE urological infections. He is an elected member of BAUS Academic section and was recently selected as a Fellow of Faculty of Surgical Trainers.
Locum Consultant Urological Surgeon
Bristol Urological Institute, North Bristol NHS TRUST
Bristol, England, United Kingdom