Abstract
Introduction: Percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) are the main methods of minimally invasive treatment of patients with nephrolithiasis. Each of these minimally invasive techniques has both advantages and disadvantages, which are the subject of intensive current research. According to the literature, limited prospective evidence exists regarding the quality of life of patients with kidney stones up to 2 cm after PCNL or RIRS.
Objective: We aimed to compare the impact of PCNL and RIRS on the quality of life of patients with kidney stones up to 2 cm in diameter.
Materials and Methods: We included 157 patients with kidney stones sized 0.9–2.0 cm (1.6±0.4 cm). PCNL was performed in 77 (49.0%) patients and RIRS in 80 (51.0%). Ureteral stenting with double J-stents was performed in all patients selected for RIRS. After RIRS, all patients received combination therapy with tamsulosin 0.4 mg+tadalafil 5 mg in the postoperative period to alleviate stent-associated symptoms. The SF-36 questionnaire, developed by Ware & Sherbourne in 1992, was used to assess quality of life (QOL). The surveys were conducted on the 4th week after minimally invasive treatment. A two-sample t-test was used. A p-value < 0.05 indicated a significant statistical difference.
Results: The total score reflecting physical functioning was higher in the RIRS group: 72 (71–73) vs 61 (60–62), p<0,001. Role-physical functioning was better in patients who underwent RIRS than in the PCNL group: 56 (55–57) vs 45 (43–46), respectively, p<0.001. Bodily pain after RIRS was less than after PCNL: 53 (52–54) vs 43 (42–44.5), p<0.001. The domains of social functioning and role-emotional functioning showed better values in patients with RIRS. General health, vitality, and mental health were similar across the comparison groups.
Conclusions: Using the SF-36 questionnaire, we found that retrograde intrarenal surgery was associated with better short-term quality-of-life outcomes than PCNL in patients with kidney stones up to 2.0 cm in diameter.