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Ureteroscopy pp 123–139Cite as

Quality of Life After Ureteroscopy

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Abstract

Ureteroscopy (URS), although a minimally invasive endoscopic procedure, can have a substantial impact on quality of life for patients. Patient and operative factors, as well as stenting, may lead to very different patient experiences. Traditionally, opioid pain medications have been a mainstay for postoperative pain management following URS, but the current epidemic of opioid addiction and abuse has necessitated a shift in the analgesic regimen for these patients. Several nonnarcotic medications offer a benefit in recovery from URS such as NSAIDs, anticholinergics, and alpha blockers. Still, interest in other alternatives to narcotics is on the rise including IV acetaminophen, beta-3 receptor agonists, and drug-eluting stents. Furthermore, proximal and distal ureteroscopy can have different recovery periods due to operative time, access sheath use, and stenting. If stenting is necessary, return to work and recovery of baseline sexual function are variable and are impacted. Patient education with thorough preoperative counseling, as well as shared decision-making, is essential to improving the patient experience with URS.

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References

  1. Denstedt JD, Wollin TA, Sofer M, Nott L, Weir M, Dah RJ. A prospective randomized controlled trial comparing nonstented versus stented ureteroscopic lithotripsy. J Urol. 2001;165(5):1419–22.

    Article  CAS  PubMed  Google Scholar 

  2. Borboroglu PG, Amling CL, Schenkman NS, Monga M, Ward JF, Piper NY, et al. Ureteral stenting after ureteroscopy for distal ureteral calculi: a multi-institutional prospective randomized controlled study assessing pain, outcomes and complications. J Urol. 2001;166(5):1651–7.

    Article  CAS  PubMed  Google Scholar 

  3. Byrne RR, Auge BK, Kourambas J, Munver R, Delvecchio F, Preminger GM. Routine ureteral stenting is not necessary after ureteroscopy and ureteropyeloscopy: a randomized trial. J Endourol. 2002;16(1):9–13.

    Article  PubMed  Google Scholar 

  4. Schuster TG, Hollenbeck BK, Faerber GJ, Wolf JS Jr. Complications of ureteroscopy: analysis of predictive factors. J Urol. 2001;166(2):538–40.

    Article  CAS  PubMed  Google Scholar 

  5. Joshi HB, Newns N, Stainthorpe A, MacDonagh RP, Keeley FX Jr, Timoney AG. Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J Urol. 2003;169(3):1060–4.

    Article  CAS  PubMed  Google Scholar 

  6. Penniston KL, Nakada SY. Development of an instrument to assess the health related quality of life of kidney stone formers. J Urol. 2013;189(3):921–30.

    Article  PubMed  Google Scholar 

  7. Penniston KL, Antonelli JA, Viprakasit DP, Averch TD, Sivalingam S, Sur RL, et al. Validation and reliability of the Wisconsin stone quality of life questionnaire. J Urol. 2017;197(5):1280–8.

    Article  PubMed  Google Scholar 

  8. Nelson LS, Juurlink DN, Perrone J. Addressing the opioid epidemic. JAMA. 2015;314(14):1453–4.

    Article  CAS  PubMed  Google Scholar 

  9. Hydrocodone/acetaminophen [Internet]. Epocrates. Available from: https://online.epocrates.com/drugs/12210/hydrocodone-acetaminophen/Monograph.

  10. Pathan SA, Mitra B, Straney LD, Afzal MS, Anjum S, Shukla D, et al. Delivering safe and effective analgesia for management of renal colic in the emergency department: a double-blind, multigroup, randomised controlled trial. Lancet. 2016;387(10032):1999–2007.

    Article  CAS  PubMed  Google Scholar 

  11. Sobel D, Cisu T, Pham A, Stearns G, Sternberg K. PD53-07 the feasibility of discharging patients without opioids after ureteroscopy. J Urol. 2018;199(4):e1048–e9.

    Google Scholar 

  12. Caldwell JR. Efficacy and safety of diclofenac sodium in rheumatoid arthritis. Experience in the United States. Am J Med. 1986;80(4B):43–7.

    Article  CAS  PubMed  Google Scholar 

  13. Masoumi K, Forouzan A, Asgari Darian A, Feli M, Barzegari H, Khavanin A. Comparison of clinical efficacy of intravenous acetaminophen with intravenous morphine in acute renal colic: a randomized, double-blind, controlled trial. Emerg Med Int. 2014;2014:571326.

    PubMed  PubMed Central  Google Scholar 

  14. Sin B, Koop K, Liu M, Yeh JY, Thandi P. Intravenous acetaminophen for renal colic in the emergency department: where do we stand? Am J Ther. 2017;24(1):e12–e9.

    Article  PubMed  Google Scholar 

  15. Flynn K, Guidos P, Francis S, Simmering J, Polgreen P, Tracy C, et al. MP80-05 outcomes from a text messaging study performed to better predict post-ureteroscopy opioid use. J Urol. 2018;199(4):e1090–e1.

    Google Scholar 

  16. Raffa RB, Friderichs E, Reimann W, Shank RP, Codd EE, Vaught JL, et al. Complementary and synergistic antinociceptive interaction between the enantiomers of tramadol. J Pharmacol Exp Ther. 1993;267(1):331–40.

    CAS  PubMed  Google Scholar 

  17. Scott LJ, Perry CM. Tramadol: a review of its use in perioperative pain. Drugs. 2000;60(1):139–76.

    Article  CAS  PubMed  Google Scholar 

  18. Lamb AD, Vowler SL, Johnston R, Dunn N, Wiseman OJ. Meta-analysis showing the beneficial effect of alpha-blockers on ureteric stent discomfort. BJU Int. 2011;108(11):1894–902.

    Article  PubMed  Google Scholar 

  19. Abrams P, Speakman M, Stott M, Arkell D, Pocock R. A dose-ranging study of the efficacy and safety of tamsulosin, the first prostate-selective alpha 1A-adrenoceptor antagonist, in patients with benign prostatic obstruction (symptomatic benign prostatic hyperplasia). Br J Urol. 1997;80(4):587–96.

    Article  CAS  PubMed  Google Scholar 

  20. Cheung CM, Awan MA, Sandramouli S. Prevalence and clinical findings of tamsulosin-associated intraoperative floppy-iris syndrome. J Cataract Refract Surg. 2006;32(8):1336–9.

    Article  PubMed  Google Scholar 

  21. Bailey G, Vaughan L, Rose C, Krambeck A. Perinatal outcomes with Tamsulosin therapy for symptomatic urolithiasis. J Urol. 2016;195(1):99–103.

    Article  CAS  PubMed  Google Scholar 

  22. Baigrie RJ, Kelleher JP, Fawcett DP, Pengelly AW. Oxybutynin: is it safe? Br J Urol. 1988;62(4):319–22.

    Article  CAS  PubMed  Google Scholar 

  23. Scheife R, Takeda M. Central nervous system safety of anticholinergic drugs for the treatment of overactive bladder in the elderly. Clin Ther. 2005;27(2):144–53.

    Article  CAS  PubMed  Google Scholar 

  24. Lee FC, Holt SK, Hsi RS, Haynes BM, Harper JD. Preoperative belladonna and opium suppository for ureteral stent pain: a randomized, double-blinded. Placebo-Control Stud Urol. 2017;100:27–32.

    Google Scholar 

  25. Park YC, Tomiyama Y, Hayakawa K, Akahane M, Ajisawa Y, Miyatake R, et al. Existence of a beta3-adrenoceptro and its functional role in the human ureter. J Urol. 2000;164(4):1364–70.

    Article  CAS  PubMed  Google Scholar 

  26. Matsumoto R, Otsuka A, Suzuki T, Shinbo H, Mizuno T, Kurita Y, et al. Expression and functional role of beta3 -adrenoceptors in the human ureter. Int J Urol. 2013;20(10):1007–14.

    CAS  PubMed  Google Scholar 

  27. Nitti VW, Khullar V, van Kerrebroeck P, Herschorn S, Cambronero J, Angulo JC, et al. Mirabegron for the treatment of overactive bladder: a prespecified pooled efficacy analysis and pooled safety analysis of three randomised, double-blind, placebo-controlled, phase III studies. Int J Clin Pract. 2013;67(7):619–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Phenazopyridine hydrochloride [Internet]. Epocrates. Available from: https://online.epocrates.com/drugs/1160/Pyridium.

  29. Mosli HA, Farsi HM, Al-Zimaity MF, Saleh TR, Al-Zamzami MM. Vesicoureteral reflux in patients with double pigtail stents. J Urol. 1991;146(4):966–9.

    Article  CAS  PubMed  Google Scholar 

  30. Damiano R, Autorino R, De Sio M, Cantiello F, Quarto G, Perdona S, et al. Does the size of ureteral stent impact urinary symptoms and quality of life? A prospective randomized study. Eur Urol. 2005;48(4):673–8.

    Article  PubMed  Google Scholar 

  31. Irani J, Siquier J, Pires C, Lefebvre O, Dore B, Aubert J. Symptom characteristics and the development of tolerance with time in patients with indwelling double-pigtail ureteric stents. BJU Int. 1999;84(3):276–9.

    Article  CAS  PubMed  Google Scholar 

  32. Ho CH, Chen SC, Chung SD, Lee YJ, Chen J, Yu HJ, et al. Determining the appropriate length of a double-pigtail ureteral stent by both stent configurations and related symptoms. J Endourol. 2008;22(7):1427–31.

    Article  PubMed  Google Scholar 

  33. Rane A, Saleemi A, Cahill D, Sriprasad S, Shrotri N, Tiptaft R. Have stent-related symptoms anything to do with placement technique? J Endourol. 2001;15(7):741–5.

    Article  CAS  PubMed  Google Scholar 

  34. Chen YT, Chen J, Wong WY, Yang SS, Hsieh CH, Wang CC. Is ureteral stenting necessary after uncomplicated ureteroscopic lithotripsy? A prospective, randomized controlled trial. J Urol. 2002;167(5):1977–80.

    Article  PubMed  Google Scholar 

  35. Netto NR Jr, Ikonomidis J, Zillo C. Routine ureteral stenting after ureteroscopy for ureteral lithiasis: is it really necessary? J Urol. 2001;166(4):1252–4.

    Article  PubMed  Google Scholar 

  36. Lee C, Kuskowski M, Premoli J, Skemp N, Monga M. Randomized evaluation of ureteral stents using validated symptom questionnaire. J Endourol. 2005;19(8):990–3.

    Article  PubMed  Google Scholar 

  37. Lingeman JE, Preminger GM, Goldfischer ER, Krambeck AE, Comfort ST. Assessing the impact of ureteral stent design on patient comfort. J Urol. 2009;181(6):2581–7.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Krambeck AE, Walsh RS, Denstedt JD, Preminger GM, Li J, Evans JC, et al. A novel drug eluting ureteral stent: a prospective, randomized, multicenter clinical trial to evaluate the safety and effectiveness of a ketorolac loaded ureteral stent. J Urol. 2010;183(3):1037–42.

    Article  PubMed  Google Scholar 

  39. Mendez-Probst CE, Goneau LW, MacDonald KW, Nott L, Seney S, Elwood CN, et al. The use of triclosan eluting stents effectively reduces ureteral stent symptoms: a prospective randomized trial. BJU Int. 2012;110(5):749–54.

    Article  CAS  PubMed  Google Scholar 

  40. Barnes KT, Bing MT, Tracy CR. Do ureteric stent extraction strings affect stent-related quality of life or complications after ureteroscopy for urolithiasis: a prospective randomised control trial. BJU Int. 2014;113(4):605–9.

    Article  PubMed  Google Scholar 

  41. Hosking DH, McColm SE, Smith WE. Is stenting following ureteroscopy for removal of distal ureteral calculi necessary? J Urol. 1999;161(1):48–50.

    Article  CAS  PubMed  Google Scholar 

  42. Mushtaque M, Gupta CL, Shah I, Khanday MA, Khanday SA. Outcome of bilateral ureteroscopic retrieval of stones in a single session. Urol Ann. 2012;4(3):158–61.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Watson JM, Chang C, Pattaras JG, Ogan K. Same session bilateral ureteroscopy is safe and efficacious. J Urol. 2011;185(1):170–4.

    Article  PubMed  Google Scholar 

  44. Ingimarsson JP, Rivera M, Knoedler JJ, Krambeck AE. Same-session bilateral ureteroscopy: safety and outcomes. Urology. 2017;108:29–33.

    Article  PubMed  Google Scholar 

  45. Auge BK, Pietrow PK, Lallas CD, Raj GV, Santa-Cruz RW, Preminger GM. Ureteral access sheath provides protection against elevated renal pressures during routine flexible ureteroscopic stone manipulation. J Endourol. 2004;18(1):33–6.

    Article  PubMed  Google Scholar 

  46. Kaplan AG, Lipkin ME, Scales CD Jr, Preminger GM. Use of ureteral access sheaths in ureteroscopy. Nat Rev Urol. 2015;13:135.

    Article  PubMed  Google Scholar 

  47. Rapoport D, Perks AE, Teichman JM. Ureteral access sheath use and stenting in ureteroscopy: effect on unplanned emergency room visits and cost. J Endourol. 2007;21(9):993–7.

    Article  PubMed  Google Scholar 

  48. Torricelli FC, De S, Hinck B, Noble M, Monga M. Flexible ureteroscopy with a ureteral access sheath: when to stent? Urology. 2014;83(2):278–81.

    Article  PubMed  Google Scholar 

  49. Ahn ST, Kim JH, Park JY, du Moon G, Bae JH. Acute postoperative pain after ureteroscopic removal of stone: incidence and risk factors. Korean J Urol. 2012;53(1):34–9.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Humphreys MR, Shah OD, Monga M, Chang YH, Krambeck AE, Sur RL, et al. Dusting versus basketing during ureteroscopy-which technique is more efficacious? A prospective multicenter trial from the EDGE research consortium. J Urol. 2018;199(5):1272–6.

    Article  PubMed  Google Scholar 

  51. Penniston KL, Nakada SY. Health related quality of life differs between male and female stone formers. J Urol. 2007;178(6):2435–40; discussion 40.

    Article  PubMed  Google Scholar 

  52. Ozsoy M, Acar O, Sarica K, Saratlija-Novakovic Z, Fajkovic H, Librenjak D, et al. Impact of gender on success and complication rates after ureteroscopy. World J Urol. 2015;33(9):1297–302.

    Article  CAS  PubMed  Google Scholar 

  53. Makarov DV, Trock BJ, Allaf ME, Matlaga BR. The effect of ureteral stent placement on post-ureteroscopy complications: a meta-analysis. Urology. 2008;71(5):796–800.

    Article  PubMed  Google Scholar 

  54. Morgan MS, Antonelli JA, Lotan Y, Shakir N, Kavoussi N, Cohen A, et al. Use of an electronic medical record to assess patient-reported morbidity following ureteroscopy. J Endourol. 2016;30(Suppl 1):S46–51.

    Article  PubMed  Google Scholar 

  55. Pearle MS, Lingeman JE, Leveillee R, Kuo R, Preminger GM, Nadler RB, et al. Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less. J Urol. 2008;179(5 Suppl):S69–73.

    PubMed  Google Scholar 

  56. Singh BP, Prakash J, Sankhwar SN, Dhakad U, Sankhwar PL, Goel A, et al. Retrograde intrarenal surgery vs extracorporeal shock wave lithotripsy for intermediate size inferior pole calculi: a prospective assessment of objective and subjective outcomes. Urology. 2014;83(5):1016–22.

    Article  PubMed  Google Scholar 

  57. Park J, Shin DW, Chung JH, Lee SW. Shock wave lithotripsy versus ureteroscopy for ureteral calculi: a prospective assessment of patient-reported outcomes. World J Urol. 2013;31(6):1569–74.

    Article  PubMed  Google Scholar 

  58. Sun X, Xia S, Lu J, Liu H, Han B, Li W. Treatment of large impacted proximal ureteral stones: randomized comparison of percutaneous antegrade ureterolithotripsy versus retrograde ureterolithotripsy. J Endourol. 2008;22(5):913–7.

    Article  PubMed  Google Scholar 

  59. Giannarini G, Keeley FX Jr, Valent F, Manassero F, Mogorovich A, Autorino R, et al. Predictors of morbidity in patients with indwelling ureteric stents: results of a prospective study using the validated Ureteric Stent Symptoms Questionnaire. BJU Int. 2011;107(4):648–54.

    Article  PubMed  Google Scholar 

  60. Sighinolfi MC, Micali S, De Stefani S, Mofferdin A, Grande M, Giacometti M, et al. Indwelling ureteral stents and sexual health: a prospective, multivariate analysis. J Urol. 2007;178(1):229–31.

    Article  CAS  PubMed  Google Scholar 

  61. Eryildirim B, Tuncer M, Sahin C, Yucetas U, Sarica K. Evaluation of sexual function in patients submitted to ureteroscopic procedures. Int Braz J Urol. 2015;41(4):791–5.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Miah S, Gunner C, Clayton L, Venugopal S, Boucher NR, Parys B. Renal colic and childbirth pain: female experience versus male perception. J Pain Res. 2017;10:1553–4.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Stoller ML, Wolf JS Jr, Hofmann R, Marc B. Ureteroscopy without routine balloon dilation: an outcome assessment. J Urol. 1992;147(5):1238–42.

    Article  CAS  PubMed  Google Scholar 

  64. Voltaren. Epocrates. https://online.epocrates.com/drugs/1407/Voltaren-XR.

  65. Ultram. Epocrates. https://online.epocrates.com/drugs/1347/Ultram.

  66. Tamsulosin. Epocrates. https://online.epocrates.com/drugs/754/tamsulosin.

  67. Ditropan. Epocrates. https://online.epocrates.com/drugs/652/Ditropan-XL.

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Authors and Affiliations

  1. Department of Urology, Indiana University School of Medicine, IU Health Urology Methodist Hospital, Indianapolis, IN, USA

    Blake Anderson, Joshua M. Heiman & Amy Krambeck

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  1. Southern Illinois University, School of Medicine, Springfield, IL, USA

    Bradley F. Schwartz

  2. University of Western Ontario, London, ON, Canada

    John D. Denstedt

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Anderson, B., Heiman, J.M., Krambeck, A. (2020). Quality of Life After Ureteroscopy. In: F. Schwartz, B., D. Denstedt, J. (eds) Ureteroscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-26649-3_10

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  • DOI: https://doi.org/10.1007/978-3-030-26649-3_10

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