Relevance. In 2013, the Wisconsin Stone Quality of Life Questionnaire (WISQoL) was developed a specific tool for assessing the quality of life (QoL) in patients with urolithiasis. Aim. To determine the possibility of using the WISQoL and SF-36 questionnaires to study the treatment results of patients with kidney stones. Materials and methods. The study included 218 patients with nephrolithiasis. Patients were divided into 2 groups: the first the size of the stone up to 10 mm and the second from 11 to 20 mm. At the first stage, the efficacy of treatment patients by the extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolitholapaxy (PNL) 1 week, 1 and 3 months after surgery was compared. Questionnaires were used to study factors affecting the QOL of patients, including: gender, age, number, density and size of stones, hydronephrosis, stone free rate (SFR), type of surgery. At the next stage, the dynamics of changes in scores for the domains of questionnaires at different stages of treatment was evaluated. Results. The efficacy of treating kidney stones up to 1 cm in size after 3 months with ESWL was 86,1% and PNL 94,4 %, while stones up to 20 mm using ESWL 73,4% and percutaneous techniques 90,6%. Gender, age, stone size, SFR affected the QoL of patients with nephrolithiasis, while the number and density of stones, the presence of hydronephrosis and the type of operation were not significant. Patients 1 week after PNL had lower QoL scores in the domains of social impact and impact on vitalyty of WISQoL and mental heals of SF-36. After 1 month, these changes were determined only in the social impact domain and completely regressed by the 3rd month. Conclusion. SFR after ESWL and PNL in the first group is comparable, in the second group, percutaneous operations were 17,2% more effective. Male gender, age up to 40 years, stone size more than 1 cm, and also not reached SFR negatively affects patients with nephrolithiasis. Compared with ESWL and PNL is accompanied by the worst dynamics of QOL scores only 1 week after the operation; upon further observation, negative changes are leveled.
Introduction. In modern scientific literature it is becoming increasingly popular to study Quality of Life (QoL) index as an integral indicator of the entire therapeutic complex. QoL along with physical examination, laboratory and instrumental tests allows a doctor to fully assess patient’s condition. That is why the QoL researches has been recently become more and more widespread in the scientific papers. Aim. The aim of this study was to determine applicability of the Wisconsin Stone Quality of Life Questionnaire (WISQOL) and the SF-36 General Questionnaire for evaluating treatment outcomes and postoperative follow-up in patients with ureterolithiasis. Materials and methods. 123 patients with diagnosed urolithiasis (ureteral stone) were included in the study. Clinical efficacy of the shock wave lithotripsy (SWL) and contact (laser) ureterolithotripsy (CLT) was assessed after 1 week, 1 and 3 months using stone free rate (SFR). To analyze clinical factors influencing patients QoL, differences in the WISQOL and SF-36 total scores and scores before and after treatment were compared. At the third step, the dynamics of QoL indicators at different stages of treatment was analyzed. Results. The SFR at 1 week, 1 and 3 months after SWL and CLT were 47,1%, 58,8%, 72,5% and 6,4%, 84,7, 93,1% respectively. Gender, age, stone size and the Stone Free Rate achieved during treatment had a significant effect on QoL (p <0.05), while localization and density of a stone showed no effect. According to the WISQOL and SF-36 questionnaire, 1 week after CLT patients had lower levels of QoL, than after SWL (p < 0.05), but after 1 month the QoL for SWL and CLT reached the same levels and by 3 months became submaximal. Conclusions. Despite the higher rates of clinical efficacy, CLT showed lower QoL levels in the early postoperative period. Male sex, age up to 40 years, stone size more than 7 mm, and not achieved SFR during treatment contribute to lower QoL. To assess the dynamics of QoL levels in patients with ureterolithiasis, it is advisable to use the WISQOL.
Carcinosarcoma is an exceedingly rare and highly aggressive malignant tumor. Some patients with carcinosarcoma have normal levels of prostate specific antigen; therefore, digital rectal examination is the only method of early diagnosis in them. In this article, we report a case of prostate carcinosarcoma and describe its diagnosis and treatment.
The aim of the study was to study the clinical efficiency and safety of the drug uriklar in extracorporeal shock wave lithotripsy (ESWL) and early metaphylaxis of urolithiasis. Materials and methods. 45 patients were included in the prospective study. The patients were divided into two groups. The main group consisted of 25 patients, they received uriklar 1 capsule three times a day for one month before and three after ESWL. The control group included 20 patients who underwent ESWL only. Uriklar is combined drug with citrate and herbal components. Results. The total efficiency of ESWL was 92% in I group versus 75% in control group. Among the patients of the main group, the frequency of renal colic after ESWL was 24% (6 patients), while in the control group colic occurred in 9 patients (45%). The severity of pain syndrome was of 5.12 ± 2.1 in I group and of 7.48 ± 2.2 and in II group (p < 0.05). Uriklar in the first group of patients increased the pH of urine and the excretion of citrate significantly and decreased excretion of uric acid. After 3 months, the vast majority of patients (n = 24, 96%) of the main group underwent curing of the urinary tract, and daily diuresis remained at 2.3 ± 0.3 l/day. Conclusions. The uriklar taking increases the fragmentation of urinary stones and the elimination of the resulting fragments from the urinary tract, promotes the normalization of metabolic disorders, and effectively eliminates infectious-inflammatory complications of urolithiasis. It is also well-tolerated and has no side effects. (For citation: Shestaev AYu, Protoshchak VV, Paronnikov MV, Kiselev AO. Combined (citrate and herbal) drug uriklar in extracorporeal shock wave lithotripsy and metaphylaxis of urolithiasis. Urologicheskie vedomosti. 2018;8(1):19-25. doi: 10.17816/uroved8119-25).
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