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

Objective To prospectively capture patient-reported outcomes to assess the recovery profile of ureteroscopy. Materials and Methods Adults undergoing ureteroscopy for renal/ureteral stones were eligible for inclusion (11/2020-8/2022). Patients prospectively completed PROMIS – Pain Intensity, -Pain Interference, and -Ability to participate in social roles and activities in-person pre-operatively (POD 0) and via email on POD 1, 7, 14 and 30. Scores are reported as T-scores (normalized to US pop., mean=50) with a change of 5 (0.5 SD) considered clinically significant. Results 178 participants enrolled at POD 0 (POD 1=87, POD 7=83, POD 14=70, POD30=67). There was a worsening of quality of life from day 0 to day 1 and day 0 to 7. All dimensions then improved with an increase in scores from day 0 to day 14 and day 0 to day 30. On multivariable analysis, the presence of a pre-operative ureteral stent (OR 0.14) and use of semi-rigid ureteroscopy (OR 0.33) were associated with a reduced odds for severe pain interference at day 1. The use of semi-rigid ureteroscopy (OR 0.20) was associated with a reduced odds for severe worsening in the ability to participate in social roles at day 1. Conclusions Ability to participate in social roles declines immediately post-operatively, while pain intensity and interference sharply increase. There is a gradual improvement until POD 30. Findings suggest pre-operative stents may influence post-operative recovery. Results offer meaningful insight to assist in counseling and setting expectation for patients post-operatively.