Percutaneous nephrolithotomy: short- and long-term effects on health-related quality of life.
OBJECTIVE
Percutaneous nephrolithotomy (PCNL) is the treatment of choice for large and complex kidney stones, having increased its safety and effectiveness over the last years. Nonetheless, there is little known about its impact on quality of life (QoL). This study aimed at evaluating the effects of PCNL on patients' QoL in the short and long term.


METHODS
We prospectively studied 40 consecutive cases who underwent PCNL. QoL was measured using the short form-36 (SF-36) questionnaire, 2 weeks before surgery and then in the third postoperative month and a year after. Changes in QoL were assessed under statistical and clinical relevance criteria.


RESULTS
PCNL has rendered 70% of the cases completely stone free with a 35% complication rate (33% Clavien I+II). The baseline scores of all SF-36 domains were worse than the referral population. Three months after PCNL, bodily pain was the only dimension whose change was relevant for patients (effect size [ES]=0.71, minimal clinically important difference [MCID]=0.56). A year after, this favorable effect of PCNL on body pain is still present, being also beneficial on both role physical (ES=0.58, MCID=0.52) and the physical component summary (ES=0.56, MCID=0.43). Social function was also close to reaching clinical relevance a year after the procedure (ES=0.66, MCID=0.72).


CONCLUSIONS
Kidney stone disease considerably affects the patients' QoL. PCNL not only has good outcomes rendering the kidney stone free without major complications but produces an immediate body pain relief. This is perceived as relevant by the patients even a year after the procedure, when some other physical aspects of QoL also get better, helping patients to restore their social activities.
1 Department of Urology, Complejo Hospitalario Universitario de Santiago de Compostela , Santiago de Compostela, Spain .
Daniel Adolfo
DA
Pérez-Fentes
Francisco
F
Gude
Benito
B
Blanco
Camilo García
CG
Freire
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome