title: Do the residual fragments after shock wave lithotripsy affect the quality of life?
abstract: OBJECTIVE
  To evaluate the possible effects of residual fragments on the health-related quality of life in patients undergoing extracorporeal shockwave lithotripsy for renal stones.
  
  
  METHODS
  Seventy-one patients with residual fragments were divided into 2 further groups; group 1 (n = 42; fragment size, ≤ 4 mm) and group 2 (n = 29; fragment size, >4 mm). During 3-month follow-up, spontaneous passage rates; number of emergency department visits, amount of the analgesic required, additional procedures, and the changes in the quality of life were evaluated. Quality of life was evaluated using the Short Form 36 survey. Statistical analyses included independent sample t tests.
  
  
  RESULTS
  Of the 42 cases with fragments ≤ 4 mm, although 92.8% patients passed the fragments spontaneously, fragments resided until 3 months in 4.8% patients. Again, after 2 sessions of extracorporeal shockwave lithotripsy, of the 29 cases with fragments >4 mm, 55% were stone free, whereas 14% still had residual fragments. Mean number of emergency department visit was found to be 0.07 and 0.5 in both groups, respectively. Mean analgesic need was 138.75 mg in group 1 and 375 mg in group 2. Although significantly lower scores were noted only for one parameter during 1-month evaluation in cases with larger fragments, they were present in all 8 parameters during 3-month evaluation.
  
  
  CONCLUSIONS
  Larger residual fragments could significantly affect the quality of life. Emergency department visits and colic attacks are the causes of discomfort. Effective stone disintegration by an experienced urologist should be aimed to limit the negative effects of residual fragments on the quality of life.
authors.affiliation: Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey. Electronic address: cahitsahin129@gmail.com.
authors.forename: Cahit
authors.initials: C
authors.lastname: Sahin
authors.affiliation: Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Tuncer
authors.affiliation: Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Yazıcı
authors.affiliation: Faculty of Medicine, Urology Clinic, Medipol University, Istanbul, Turkey.
authors.forename: Rahim
authors.initials: R
authors.lastname: Horuz
authors.affiliation: Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
authors.forename: A Cihangir
authors.initials: AC
authors.lastname: Çetinel
authors.affiliation: Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
authors.forename: Bilal
authors.initials: B
authors.lastname: Eryıldırım
authors.affiliation: Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Tarhan
authors.affiliation: Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Sarica
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000523:psychology* / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D055502:Secondary Prevention; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014572:Urology / Q000379:methods
chemical_list: D000700:Analgesics