The effect of SWL and URS on health-related quality of life in proximal ureteral stones

Objectives: We aimed to compare the effect of shock wave lithotripsy (SWL) and ureteroscopic lithotripsy (URS) on health-related quality of life (HRQoL) for the treatment of proximal ureteral stones. Material and methods: Between April 2014 and July 2015, patients with proximal ureteral stones who were successfully treated with URS or SWL in seven different centers were included. Patients were divided into two groups according to stone size: stones <= 10 mm and >10mm. HRQoL subscales which were evaluated by the Medical Outcome Study Short-Form 36-item survey (SF-36) Turkish version were compared for URS and SWL in these two groups one month after the performed procedure. Results: A total of 273 patients were included in the study. While 116 (52.5%) patients were treated with ureteroscopic lithotripsy, SWL was used for 105 (47.5%) patients. Fifty-two patients were excluded from the study. In proximal ureteral stones <= 10 mm, there were no statistically significant differences for any of the eight subscales of the SF-36 questionnaire. Regarding stones >10mm, it was found that the three subscales of the SF-36 questionnaire - role limitations because of physical health problems (RP), bodily pain (BP), and general health perception (GH) - were significantly lower in the SWL group compared with the URS group. Conclusions: Patients with proximal ureteral stones >10mm who were treated with URS generally may have a more favorable HRQoL than those treated with SWL in short-term follow-up.