Quality of life impact and recovery after ureteroscopy and stent insertion: insights from daily surveys in STENTS.

TitleQuality of life impact and recovery after ureteroscopy and stent insertion: insights from daily surveys in STENTS.
Publication TypeJournal Article
Year of Publication2022
AuthorsHarper JD, Desai AC, Antonelli JA, Tasian GE, Ziemba JB, Al-Khalidi HR, H Lai H, Maalouf NM, Reese PP, Wessells HB, Kirkali Z, Scales CD
Corporate AuthorsNIDDK Urinary Stone Disease Research Network(USDRN)
JournalBMC Urol
Volume22
Issue1
Pagination53
Date Published2022 Apr 06
ISSN1471-2490
KeywordsAdult, Female, Humans, Lower Urinary Tract Symptoms, Pain, Prospective Studies, Quality of Life, Stents, Surveys and Questionnaires, Ureter, Ureteral Calculi, Ureteroscopy
Abstract

BACKGROUND: Our objective was to describe day-to-day evolution and variations in patient-reported stent-associated symptoms (SAS) in the STudy to Enhance uNderstanding of sTent-associated Symptoms (STENTS), a prospective multicenter observational cohort study, using multiple instruments with conceptual overlap in various domains.

METHODS: In a nested cohort of the STENTS study, the initial 40 participants having unilateral ureteroscopy (URS) and stent placement underwent daily assessment of self-reported measures using the Brief Pain Inventory short form, Patient-Reported Outcome Measurement Information System measures for pain severity and pain interference, the Urinary Score of the Ureteral Stent Symptom Questionnaire, and Symptoms of Lower Urinary Tract Dysfunction Research Network Symptom Index. Pain intensity, pain interference, urinary symptoms, and bother were obtained preoperatively, daily until stent removal, and at postoperative day (POD) 30.

RESULTS: The median age was 44 years (IQR 29,58), and 53% were female. The size of the dominant stone was 7.5 mm (IQR 5,11), and 50% were located in the kidney. There was consistency among instruments assessing similar concepts. Pain intensity and urinary symptoms increased from baseline to POD 1 with apparent peaks in the first 2 days, remained elevated with stent in situ, and varied widely among individuals. Interference due to pain, and bother due to urinary symptoms, likewise demonstrated high individual variability.

CONCLUSIONS: This first study investigating daily SAS allows for a more in-depth look at the lived experience after URS and the impact on quality of life. Different instruments measuring pain intensity, pain interference, and urinary symptoms produced consistent assessments of patients' experiences. The overall daily stability of pain and urinary symptoms after URS was also marked by high patient-level variation, suggesting an opportunity to identify characteristics associated with severe SAS after URS.

DOI10.1186/s12894-022-01004-9
Alternate JournalBMC Urol
PubMed ID35387623
PubMed Central IDPMC8988384