The quality of life of patients before and after surgical removal of bladder stones in various ways

Background . The choice of treatments should be based on the impact on the psychological, functional, social and economic lives of patients. According to the 2023 European Association of Urology (EAU) Guidelines, transurethral cystolithotripsy is safe and effective, but is associated with an increased complication rate and operating time for large stones. Suprapubic percutaneous cystolithotripsy is a minimally invasive alternative for the treatment of bladder stones and obstructive causes of their formation. Cystolithiasis and its treatment significantly affect the quality of life (QoL) of patients, which is important to evaluate in patients with bladder stones and bladder outlet obstruction after percutaneous and transurethral cystolithotripsy. Aim of the study : to compare health-related quality of life after surgery with transurethral cystolithotripsy with litholapaxy (TUC) and percutaneous suprapubic cystolithotripsy (PCCL) and to evaluate factors influencing quality of life in patients with urolithiasis. Material and methods . A total of 85 patients who suffered from cystolithiasis secondary to bladder outlet obstruction and underwent surgical treatment (the main group was percutaneous puncture cystolithotripsy, n = 40; the control group was transurethral cystolithotripsy, n = 45). All patients were administered the Short-Form 36-item survey (SF-36) and Visual Analog Scale for Pain (VAS) to assess health-related quality of life at four timepoints: before and after surgery, 1 week after, and 1 month after lithotripsy. Stone-free rates, complications, and analgesic requirements were evaluated to compare the effects of the two procedures on HRQoL. Results . After treatment, in the main group there was a statistically significant decrease in the level of pain on the VAS scale compared to the control group (p < 0.05). According to the SF-36 questionnaire, statistically significant differences in the physical and psychological functioning of patients in different study groups were also revealed (p < 0.05), which confirms the effectiveness of the treatment used in the main group. Conclusion . Quality of life after lithotripsy was higher in PCCL compared with TUC in the dynamics of the study. The presence of postoperative complications and greater postoperative pain appeared to be determinants of lower quality of life in the TUC group.