State Anxiety during Watchful Waiting for Urinary Lithiasis

Abstract

Clinicians should be more flexible when they face the above group of patients, as far as the duration of watchful waiting period is concerned, because a long waiting sets those patients under significant emotional burden.

The Role for Active Monitoring in Urinary Stones: A Systematic Review

“…18 Whether a stone of 4 mm can cause similar renal functional impairment and subsequently necessitates formal initial and follow-up renal impairment studies is unknown. 18 Taking into consideration that watchful waiting for ureteral stones <5 mm in diameter may significantly increase the patient's state of anxiety, 25 individual preferences after a thorough counseling about treatment choices, degree of invasiveness, and spectrum of complications will guide urologists and patients to select the best treatment option. 26 …”

Wertigkeit von 5 Kernaspekten der Prämedikationsvisite

“…Wartezeit bedeutet primär ein erzwungenes Stillstehen und vermittelt schnell ein Gefühl von Ohnmacht und Hilflosigkeit, ein "Sich-ausgeliefert-Fühlen". Dies wiederum kann die Möglichkeiten eines Patienten, sich effektiv mit dem Thema Narkose auseinanderzusetzen, reduzieren [20]. Meist wird Wartezeit aber nur dann als belastend empfunden, wenn sie den Betreffenden zur Untätigkeit zwingt.…”

Psychological Distress in Patients With Urolithiasis: A Systematic Review and Meta-analysis

“…Two studies reported associations between anxiety and the number of painful colic episodes in urolithiasis, 13,14 and Diniz et al 13 also reported a positive association between depression and painful colic episodes. In contrast, only 1 study reported no association between psychological distress and urolithiasis, a finding attributed to the inclusion of calcium oxalate (CaOx) stone formers only in the study sample.…”

“…Finally, lower anxiety scores were found in patients who received information from the urologist relating to their treatment and in patients that were not asked by the urologist to partake in the treatment decision-making process (eg, choosing either SWL or URS). 74 Psychological Distress and Watchful Waiting Only 1 study reported on the relationship between psychological distress and watchful waiting for urolithiasis 14 whereby state anxiety was higher for patients at the end of the waiting period, particularly if patients were male, had elevated anxiety scores pre-watchful waiting or if patients reported more than 1 stone-related pain episode in the 30day study period. 14…”

“…While there is some evidence indicating associations between psychological distress and urolithiasis, 11,12 including painful colic, 13,14 urolithiasis treatment, 11 and the time since last stone occurrence, 15 there is no consensus on the strength or the directionality of these relationships. [11][12][13][14][15][16][17] Psychological distress is common in patients with health conditions, 18 and has been linked to poorer health outcomes 19 and treatment noncompliance. 20 Thus, understanding the nature of psychological distress in the urolithiasis trajectory and providing timely psychological care is important for both patients and health care providers.…”