Determinants of health-related quality of life in patients undergoing medical expulsion therapy for acute renal colic

Abstract

Purpose:

Patients with ureteral stones and acute renal colic significantly impaired their quality of life (QOL). However, the factors that affect quality of life during conservative management, particularly medical expulsive therapy (MET), are not well understood. This study aimed to assess the determinant of QOL.

Materials and methods:

We conducted a prospective study to longitudinally assess QOL using the EuroQol-5 Dimension (EQ-5D) in patients undergoing medical expulsive therapy.

Results:

Ninety-three patients were enrolled between April 2020 and December 2022, and 187 questionnaires were completed at each visit before spontaneous passage or intervention. The study found that a higher pain intensity was significantly associated with worse QOL during the primary visit (p = 0.03). At the second visit, younger age (p < 0.01), increased frequency of renal colic attacks (p < 0.01), maximum pain intensity since the last visit (p < 0.01), and shorter time from disease onset (p = 0.03) were associated with a worse QOL. Multivariate analysis showed that only the total number of renal colic attacks was associated with EQ-5D score (p = 0.047). The stone location significantly affected the cumulative incidence of renal colic attacks (p = 0.02). The mean total number of renal colic until stone passage was 3.58 in individuals with proximal stones versus 0.86 in with distal stones (p < 0.01).

Conclusions:

This study identified pain intensity and colic frequency as key factors contributing to the decline in QOL in patients with ureteral stones. Patients with proximal stones may be good candidates for early intervention to reduce colic events.