Stephens Ella, Pietropaolo Amelia, Tear Loretta, Davis Tanya, Joshi Hrishikesh B, Somani Bhaskar K
Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
Cent European J Urol. 2022;75(4):399-404. doi: 10.5173/ceju.2022.189. Epub 2022 Nov 10.
Shock wave lithotripsy (SWL) is a well-established treatment for kidney stone disease (KSD) and despite its decreased popularity in the past, it has now gained renewed interest due to its minimally invasive nature and good outcomes, especially in the face of COVID-19 pandemic. The aim of our study was to perform a service evaluation to analyse and identify quality of life (QoL) changes [using Urinary Stones and Intervention Quality of Life (USIQoL) questionnaire] after repeat SWL treatments. This would enable a greater understanding of SWL treatment and reduce the current gap of knowledge regarding patient specific outcomes in the field.
Patients affected by urolithiasias underwent SWL treatment between September 2021 and February 2022 (6 months), were included in the study. A questionnaire was given to the patients in each SWL session and consisted of three main topic areas: a domain on Pain and Physical Health, on Psycho-social Health and on Work (see appendix below). Patients also completed a Visual Analogue Scale (VAS) in relation to the pain related to the treatment. Data from the questionnaires were collected and analysed.
A total of 31 patients filled in two or more surveys, with a mean age of 55.8 years. On repeat treatments, pain and physical health domain was significantly better (p = 0.0046), psycho-social health domain was significantly better (p <0.001), work domain was significantly better (p = 0.009) and a correlation [on Visual Analog Scale (VAS)] was observed between pain decreasing in subsequent SWL procedures.
Our study found that the choice of SWL to treat KSD does improve a patient's QoL. This could be related to improvement of physical health, psychological and social wellbeing, and ability to work. Higher QoL and low pain scores are observed in relation to repeat SWL treatment and are not directly associated to stone-free status.
冲击波碎石术（SWL）是治疗肾结石疾病（KSD）的一种成熟方法。尽管过去其受欢迎程度有所下降，但由于其微创性质和良好疗效，特别是在面对新冠疫情的情况下，现在它又重新引起了人们的关注。我们研究的目的是进行一项服务评估，以分析并确定重复进行SWL治疗后生活质量（QoL）的变化[使用尿路结石与干预生活质量（USIQoL）问卷]。这将有助于更深入地了解SWL治疗，并缩小该领域目前关于患者特定结局的知识差距。
纳入2021年9月至2022年2月（6个月）期间接受SWL治疗的尿石症患者。在每次SWL治疗时向患者发放一份问卷，问卷包括三个主要主题领域：疼痛与身体健康领域、心理社会健康领域和工作领域（见下文附录）。患者还完成了与治疗相关疼痛的视觉模拟评分（VAS）。收集并分析问卷数据。
共有31名患者填写了两份或更多份调查问卷，平均年龄为55.8岁。在重复治疗时，疼痛与身体健康领域显著改善（p = 0.0046），心理社会健康领域显著改善（p <0.001），工作领域显著改善（p = 0.009），并且在后续SWL治疗中观察到疼痛减轻之间存在相关性[基于视觉模拟评分（VAS）]。
我们的研究发现，选择SWL治疗KSD确实能改善患者的生活质量。这可能与身体健康、心理和社会幸福感以及工作能力的改善有关。与重复SWL治疗相关的是更高的生活质量和更低的疼痛评分，且与结石清除状态无直接关联。
