How post-URS QOL data can help with patient counseling

In this video, Justin B. Ziemba, MD, MSEd, shares the take-home message from the Urology study “Post-Operative Recovery of Quality-of-Life Following Ureteroscopy for Nephrolithiasis: The Impact on Pain Intensity and Interference and the Ability to Participate in Social Roles.” Ziemba is Co-Chair of the UPHS Graduate Medical Education Subcommittee for Quality & Safety in the Clinical Learning Environment and an assistant professor of urology in surgery at the Hospital of the University of Pennsylvania, Philadelphia.

Transcription:

What questions arise out of this research?

[There are] a couple [questions]. One is why does the post operative ureteral stent not seem to impact the recovery trajectory? We've seen that in other studies. But other studies haven't really looked at these dimensions specifically. So it could be that we're not capturing it, or patients are not feeling it and being able to report it based on pain interference or social ability, just because they're recovering in general and don't want to interact with their family and friends in that first week, and the stent has little impact on that; they were going to not do it anyways. Although that's, purely hypothetical, we'd have to do some more in-depth interviews to figure out why that might be. And then I think the other piece that's really important that we haven't pulled out, but are hoping to do in the future is that these are summary statistics or summary metrics that we included in this study. But each individual question of these questionnaires has data in it. And so are there very, very specific dimensions, where people have difficulty in terms of that specific area in recovery, like specifically taking care of family members or family obligations; is that worse than social obligations such as with friends outside of the house? We can look deeper into that data and find out so that we can use that information to study those a little bit more or to provide more patient-centric recovery information.

What is the take-home message for the practicing urologist?

I'd say for the practicing urologist, we know that surgical intervention for ureteroscopy for both renal and ureteral stones does result in a relatively rapid and also quite substantial improvement in quality of life that does exceed preoperative baseline. Despite the fact that the first 1 to 7 days after surgery, there is some severe pain and limitations on social functioning. And so that information can be used right now. We don't have to wait for other data to come in, that you can use that information to counsel your patients preoperatively explicitly about what they should expect in that 1 week after surgery, so they can be prepared, they can have the right expectations, they can get their family and work obligations set up so that they know what's going to be impacted in the recovery pattern.

This transcription was edited for clarity.