Health-related quality of life after thulium fiber laser lithotripsy: a prospective study according to stone localization

To evaluate postoperative changes in health-related quality of life (HRQoL) after endoscopic stone surgery and to determine whether recovery patterns differ according to stone localization. In this prospective observational study, 50 patients undergoing endourological stone surgery were stratified according to stone localization (renal, ureteral, and bladder). HRQoL was assessed using the SF-36 questionnaire preoperatively, on postoperative day 1, and at 1, 3, and 6 months. Stone-free status was evaluated at postoperative month 1 using KUB radiography and/or non-contrast CT when clinically indicated. Statistical analysis was performed using mixed-design repeated-measures ANOVA, with appropriate assumption testing. SF-36 total scores and all subscale scores improved significantly over time in all groups (p < 0.001). No significant overall differences were observed between localization groups (p > 0.05), whereas a significant group × time interaction was detected (p = 0.005), suggesting differences in recovery patterns according to stone localization. Patients with ureteral stones demonstrated a faster improvement in the bodily pain domain (p = 0.002). Stone-free rates were high across groups (100% bladder, 94.7% ureteral, and 92.6% renal stones). Endoscopic stone surgery is associated with significant improvements in HRQoL across all stone localizations. Although recovery patterns vary according to stone location, overall functional and psychosocial outcomes improve consistently over time. However, given the observational design and lack of a comparator group, modality-specific conclusions cannot be drawn.