Patients' perception of surgical outcomes and quality of life after retroperitoneoscopic and open pyeloplasty.
OBJECTIVE
To report postoperative health-related quality of life (HRQoL) and patients' subjective evaluations of open pyeloplasty (OP) and retroperitoneoscopic pyeloplasty (RP) and influences on preoperative counselling.


METHODS
107 patients (age 16-80 years, mean 31.5) with symptomatic primary ureteropelvic junction obstruction who underwent OP (32) or RP (75) were evaluated prospectively. HRQoL was evaluated using Short Form 36 (SF-36) questionnaires with 1 year follow-up. Operative outcomes were evaluated using a self-designed questionnaire regarding cosmetic outcomes, objective postoperative/current pain, convalescence and return to work.


RESULTS
The mean operative time was 174.4 vs. 161.4 min for RP versus OP, respectively, without intraoperative complications/conversions. There was an advantage for RP--except for two domains--without significance in any of the eight SF-36 domain scores. An advantage favouring RP in all aspects of the second questionnaire with significance in four aspects (cosmetic results, scar length, pain and convalescence) was found. Five weeks postoperatively, 58.7% (RP) vs. 25.8% (OP) were fully convalescent compared to 87.0% (RP) vs. 71.0% (OP) at 8 weeks. Similarly, 58.7 vs. 45.1% returned work 5 weeks postoperatively while 93.5 vs. 74.2% did so after 8 weeks, respectively. The small sample size, more questions on satisfaction/regret and mixed design are the main study limitations.


CONCLUSIONS
RP provides the same functional results beside earlier convalescence, better HRQoL and patients' convenience with surgery, which favours its inclusion in preoperative counselling providing patients with realistic postoperative expectations.
Department of Urology, University Hospital Munich-Grosshadern, Ludwig Maximilian University Munich, Munich, Germany.
Wael Y
WY
Khoder
Raphaela
R
Waidelich
Armin J
AJ
Becker
Alexander
A
Karl
Nicolas
N
Haseke
Ricarda M
RM
Bauer
Christian G
CG
Stief
Alexander
A
Bachmann
Nicole
N
Ebinger Mundorff
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002921:Cicatrix / Q000209:etiology; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010465:Perception; D011446:Prospective Studies; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012187:Retroperitoneal Space / Q000601:surgery; D062707:Return to Work; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult