PURPOSE To assess disease-specific and health-related QoL, anxiety and depression as well as satisfaction regarding retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mPCNL) intervention for kidney stones up to 2.5 cm. Secondarily, pain as well as perioperative and postoperative patient outcomes were evaluated. METHODS 60 consecutive patients with kidney stones of dimensions not exceeding 2.5 cm were enrolled in the study of which 30 underwent RIRS and 30 mPCNL. Perioperative characteristics (age, gender, body mass index (BMI), stone side and size, previous interventions for kidney stones and duration of hospitalization) and surgical outcomes (hemoglobin drop, stone-free rate, visual analogue scale (VAS), stenting time, size of ureteral access sheath (UAS) deployment, and postoperative complications) of patients were collected. Quality of life and psychological outcomes were evaluated using validated questionnaires. RESULTS No significant differences were found between the two groups in terms of age, gender, BMI, stone side and size (p > 0.05). Significant differences between the mPCNL and the RIRS groups were found regarding stenting time (p = 0.032) and duration of hospital stay (p 0.05). Peri- and postoperative complications were not statistically different between the two groups (p > 0.05). RIRS group reported higher anxiety and depression scores compared with the mPCNL group (3 [range 0-15] vs 15 [range 6-24], p < 0.01). We found significant differences between the two groups in social (p < 0.05) and vitality (p < 0.01) scores. VAS pain score was significantly lower in the mPCNL group than in the RIRS one (p < 0.05). CONCLUSIONS These results open new scenarios in the treatment of kidney stones up to 2.5 cm when RIRS and mPCNL have interchangeable indications. Since in our experience complications and success rate are similar, the surgical choice of switching from RIRS to mPCNL in real-time and viceversa may be proposed to the patient in the preoperative counseling.

/pdf/clinical-and-psychological-outcomes-of-patients-undergoing-5g5dq7qhqp.pdf

Clinical and psychological outcomes of patients undergoing Retrograde Intrarenal Surgery and Miniaturised Percutaneous Nephrolithotomy for kidney stones. A preliminary study.

Objective: To compare three groups of patients who underwent uncomplicated ureteroscopic lithotripsy (URSL) and to evaluate whether stenting could be eliminated after the procedure, as there is no ...

https://www.tandfonline.com/doi/pdf/10.1080/2090598X.2020.1762280

Ureteric stenting vs not stenting following uncomplicated ureteroscopic lithotripsy: A prospective randomised trial

Ureteric stents are conventionally used in daily urological practice. There is ongoing debate on the superiority of different stent materials, particularly in terms of patient tolerance. We conducted a literature review to compare silicone stents and stents made of other materials from a patient tolerability perspective. We conclude that silicone stents are better tolerated but further research is required.

/pdf/silicone-vs-polyurethane-stent-the-final-countdown-2znxogce.pdf

Silicone vs. Polyurethane Stent: The Final Countdown

Abstract Ureteral stents have a major role in urology and are used mainly to achieve correct renal drainage. Ureteral stents are very effective and their use in recent decades has clearly increased. However, more than 80% of patients with an ureteral stent present associated symptoms, such as pain, lower urinary tract symptoms (LUTS), sexual dysfunction… leading to an important drop in the quality of life (QoL). Our objective is to describe ureteral stent related symptoms and their impact on the quality of life of patients. 

/pdf/ureteral-stents-impact-on-patients-quality-of-life-2bukd9fq.pdf

Ureteral Stents. Impact on Patient’s Quality of Life

Re: Ranan Dasgupta, Sarah Cameron, Lorna Aucott, et al. Shockwave Lithotripsy Versus Ureteroscopic Treatment as Therapeutic Interventions for Stones of the Ureter (TISU): A Multicentre Randomised Controlled Non-inferiority Trial. Eur Urol 2021;80:46-54.

Ureteral stents have an indispensable place in urology, and indications for their use are increasing. However, stents can affect their users' quality of life negatively because of complications and adverse effects. This descriptive research aimed to determine the effect of ureteral stenting on quality of life. The study sample consisted of 75 patients. Data were collected using a questionnaire form, the SF-36 Quality of Life Scale, and the International Prostate Symptom Score. Patients were interviewed twice (before stenting and 1 month after stenting). The data were analyzed with descriptive statistics methods. This research determined that patients with ureteral stents had increased lower urinary tract symptoms and significantly reduced quality of life.

Ureteral Stents: Impact on Quality of Life.

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Ureteral Stents: Impact on Quality of Life.