Bensalah Karim, Tuncel Altug, Raman Jay D, Bagrodia Aditya, Pearle Margaret, Lotan Yair
Department of Urology, University of Texas Southwestern Medical Center Dallas, Texas 75390-9110, USA.
J Urol. 2009 Sep;182(3):998-1004. doi: 10.1016/j.juro.2009.05.025. Epub 2009 Jul 18.
We compared patient and urologist perceptions regarding the medical management of stone disease.
A total of 159 patients were prospectively interviewed. Patients were asked 3 questions concerning subjective tolerance of stone passage and surgical intervention weighed against the use of daily preventive medication. The same questions were sent to members of the Endourological Society.
Mean +/- SD patient age was 51 +/- 14 years. Recurrent stone formers comprised 72% of patients and 76% had undergone a prior surgical procedure while 43% were taking prophylactic medication. Overall 81% and 88% of patients responded that they would rather take medication than tolerate a single stone event at home or in the emergency room, respectively. Likewise 92% of patients stated that they would prefer daily medication compared to any surgical procedure. Among 61 urologists 26%, 38% and 18% responded that patients would likely tolerate 1, 2 or an unlimited number of stone passages at home, respectively, before agreeing to take medication. Of the urologists 66% estimated that patients would tolerate up to 2 acute stone events requiring an emergency room visit before starting medication. In addition 20%, 31% and 33% of urologists presumed that patients would accept the need for surgery annually, every other year or every third year rather than take medication.
Most patients with stones will consider preventive medical therapy to avoid recurrent pain or a surgical procedure. In contrast, most urologists perceive that patients prefer to avoid medication even if it means tolerating several acute stone events and/or surgical procedures.
我们比较了患者和泌尿外科医生对结石病药物治疗的看法。
前瞻性地访谈了共159名患者。询问患者3个问题，内容涉及结石排出的主观耐受性以及与使用日常预防性药物相比的手术干预。向腔内泌尿外科协会成员发送了相同的问题。
患者的平均年龄±标准差为51±14岁。复发性结石形成者占患者的72%，76%曾接受过先前的手术，43%正在服用预防性药物。总体而言，分别有81%和88%的患者表示，他们宁愿服药也不愿在家中或急诊室忍受单次结石发作。同样，92%的患者表示，与任何手术相比，他们更喜欢日常服药。在61名泌尿外科医生中，分别有26%、38%和18%的医生回答说，患者在同意服药之前可能会在家中忍受1次、2次或不限次数的结石排出。66%的泌尿外科医生估计，患者在开始服药之前会忍受多达2次需要急诊室就诊的急性结石发作。此外，分别有20%、31%和33%的泌尿外科医生推测，患者会接受每年、每两年或每三年进行一次手术而不是服药。
大多数结石患者会考虑预防性药物治疗以避免反复疼痛或手术。相比之下，大多数泌尿外科医生认为，患者宁愿避免服药，即使这意味着忍受几次急性结石发作和/或手术。
