The impact of watching real-time videos of flexible ureteroscopic lithotripsy on anxiety and depression in patients

Yang, Bin; Li, Shuqin; Mi, Yang; Wang, Jinyao; Zhang, Yangang; Wang, Jingyu

doi:10.1007/s11255-022-03164-x

“…Urinary sepsis is one of the critical illnesses. It is a sepsis caused by urinary system infection, which can cause a systemic inflammatory response, and the mortality rate is as high as 35%–75%, which seriously endangers the life safety of patients [ 11 , 12 ]. With the widespread application of endoscopic lithotripsy, postoperative ureteral sepsis has occurred frequently, and the incidence of ureteral sepsis after ureteroscopic surgery is about 4.5% [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Causes and Preventive Strategies of Urogenic Sepsis after Flexible Ureteroscopic Lithotripsy

Tan

¹

,

Xu

²

,

Wu

³

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To explore the causes of urogenic sepsis in patients after flexible ureteroscopic lithotripsy and analyze the preventive strategies. Methods. A total of 240 patients who underwent flexible ureteroscopic lithotripsy in our hospital from January 2019 to June 2022 were selected and divided into 2 groups according to whether postoperative ureteral sepsis occurred. 24 cases occurred in the observation group. Logistics multivariate regression analysis was used to analyze the risk factors of urogenic sepsis after flexible ureteroscopic lithotripsy, and the serum albumin (ALB), the peripheral blood neutrophil-to-lymphocyte ratio (NLR), and the level of procalcitonin (PCT) were correlated, and the ROC curve was used to analyze the predictive value of each index for urosepsis. Results. Univariate analysis showed that there were differences in gender, age, diabetes, stone diameter, and urine culture ratio between the two groups ( P < 0.05 ). The results of multivariate regression analysis showed that female, age ≥60 years, stone diameter >2.5 cm, and positive urine culture were the main influencing factors for the occurrence of urogenic sepsis. After operation, the ALB levels in the two groups were lower than those before operation, and the levels of NLR and PCT in the two groups were higher than those before operation; the ALB levels in the observation group were lower than those in the control group, and the NLR and PCT in the observation group were higher than those in the control group ( P < 0.05 ). According to Spearman’s correlation analysis, ALB was negatively correlated with the occurrence of uremia ( P < 0.05 ), r = −0.320, NLR and PCT were positively correlated with the occurrence of uremia ( P < 0.05 ), r = 0.313, respectively, and 0.417; in addition, Pearson’s correlation analysis showed that ALB was negatively correlated with NLR and PCT in the two groups ( P < 0.05 , r = −0.507, −0.605 in the control group, respectively, and r were −0.452 and −0.412 in the observation group). There was a positive correlation between NLR and PCT ( P < 0.05 ), r = 0.840, and there was no correlation between NLR and PCT in the observation group ( P > 0.05 ). According to the ROC curve analysis, the predictive value AUC of ALB, NLR, PCT and combined use were 0.808, 0.801, 0.901, and 0.925 ( P < 0.05 ). Conclusion. Gender, age, stone diameter, and urine culture results are the main influencing factors for the occurrence of urinary sepsis. Therefore, preventive measures should be strengthened for this group of patients. In addition, the combined use of postoperative ALT, NLR, and PCT level tests can be better.

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“…Despite advancements in urologic laparoscopic techniques and the evolution of lithotripsy and stone extraction equipment, FURL remains associated with postoperative infections, a prevalent complication (11,14). Urogenic sepsis, as the most severe perioperative complication of FURL, continues to pose challenges for urologists in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…A positive mid-section urine culture is closely associated with the development of urosepsis following FURL (9)(10)(11). The release of bacteria and endotoxins from within the stones during the procedure is a significant factor leading to urinary tract infections, Systemic Inflammatory Response Syndrome (SIRS), and potentially urosepsis (9).…”

Section: Introductionmentioning

confidence: 99%

Influence of preoperative urine culture and bacterial species on urogenital sepsis after ureteral flexible lithotripsy in patients with upper urinary tract stones

Wang,

Yu,

Qiu

et al. 2024

Front. Med.

0

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ObjectiveThis retrospective study aims to identify risk factors for urogenic sepsis in patients with upper urinary tract stones following ureteral flexible lithotripsy (FURL). Additionally, we analyze the clinical characteristics of bacterial infections post-surgery.MethodsA total of 759 patients who underwent FURL at the Urology Department of Zunyi Medical University were included. Univariate and multivariate Logistic regression analyses were conducted to identify independent risk factors for urogenic sepsis post-FURL. The distribution of bacteria based on preoperative urine cultures was also analyzed. Statistical analysis was performed using R4.2.2 software.ResultsOf the 759 patients, positive preoperative urine culture, urine nitrite positivity, urine white blood cell count (WBC) ≥ 200 cells/μL, residual stones, and neutrophil-to-lymphocyte ratio (NLR) were found to be independent risk factors for urogenic sepsis after FURL. Among the 164 patients with positive preoperative urine cultures, 32 developed urogenic sepsis post-surgery, with 68.75% having positive preoperative cultures. The leading pathogens causing postoperative urogenic sepsis were Escherichia coli (E. coli), Enterococcus faecium, Proteus mirabilis, and Klebsiella pneumoniae. The probabilities of progression to urogenic sepsis were as follows: E. coli 19% (n = 12), Enterococcus faecium 43% (n = 3), Proteus mirabilis 33.3% (n = 1), and Klebsiella pneumoniae 33.3% (n = 1). The ages of affected patients were 47.17 ± 13.2, 53.7, 41, and 79 years, respectively. Rates of comorbid diabetes were 36.4, 66.7, 50, 100%, with nitrite positivity rates at 72.7, 33.3, 50, 0%. Ten female patients were infected with E. coli, while patients infected with Klebsiella pneumoniae had an NLR of 7.62.ConclusionPositive preoperative urine culture, urine nitrite positivity, urine WBC ≥ 200 cells/μL, residual stones, and NLR are independent risk factors for urogenic sepsis after FURL. Escherichia coli is the predominant pathogen post-FURL, with notable female prevalence and nitrite-positive urine in infections. Enterococcus faecium infections are associated with diabetes.

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“…Tan et al reported lower anxiety levels in video-informed patients undergoing surgery for breast cancer [ 24 ]. In a study by Yang et al, it was shown that during flexible ureteroscopic lithotripsy, doctor-patient communication combined with real-time video significantly reduced patient anxiety and depression [ 25 ]. Similarly, we found that pre-procedural video education significantly reduced anxiety.…”

Section: Discussionmentioning

confidence: 99%

Impact of Preoperative Video-Based Education on Anxiety Levels in Patients with Renal Stones Scheduled for Flexible Ureteroscopic Lithotripsy: A Comparative Study Using APAIS and STAI

Karalar

¹

,

Demirbaş

²

,

Gercek

³

et al. 2023

Med Sci Monit

4

0

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Background Anxiety prior to surgery can impact patient outcomes and satisfaction. In light of this, our study aimed to examine the effects of preoperative video-based information versus verbal information on anxiety levels among 60 patients with renal stones slated for flexible ureteroscopic lithotripsy. Anxiety was measured using the Amsterdam Pre-Operative Anxiety and Information Scale (APAIS) and the State-Trait Anxiety Inventory (STAI). Material/Methods We enrolled 60 patients with renal stones who were scheduled for flexible ureteroscopic lithotripsy. These patients were divided randomly into two groups: Group 1 (30 patients) received preoperative video-based information and Group 2 (30 patients) received only verbal information. Anxiety levels were assessed preoperatively using both the APAIS and STAI. On the first postoperative day, each patient indicated their pain using a visual analogue scale and filled out a questionnaire about their willingness to undergo the procedure again. Results Group 1 exhibited lower anxiety levels as reflected by the APAIS scores for anesthesia ( P =0.02), surgery ( P <0.001), overall ( P <0.001), and information needs ( P <0.001). While there was no significant difference in the STAI-trait anxiety scores between the groups ( P =0.15), Group 2 demonstrated notably higher anxiety levels concerning the surgical procedure, as measured by the STAI-state scores ( P <0.001). The average pain score was 4.23±2.17 for Group 1 and 5.37±2.83 for Group 2 ( P =0.08). Patients in Group 1 showed a greater willingness to undergo the surgery again ( P =0.02). Conclusions Delivering preoperative information through videos significantly diminishes anxiety levels in patients about to undergo retrograde intrarenal surgery compared to traditional verbal communication.

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The impact of watching real-time videos of flexible ureteroscopic lithotripsy on anxiety and depression in patients

Cited by 5 publications

References 21 publications

Analysis of the Causes and Preventive Strategies of Urogenic Sepsis after Flexible Ureteroscopic Lithotripsy

Analysis of the Causes and Preventive Strategies of Urogenic Sepsis after Flexible Ureteroscopic Lithotripsy

Influence of preoperative urine culture and bacterial species on urogenital sepsis after ureteral flexible lithotripsy in patients with upper urinary tract stones

Impact of Preoperative Video-Based Education on Anxiety Levels in Patients with Renal Stones Scheduled for Flexible Ureteroscopic Lithotripsy: A Comparative Study Using APAIS and STAI

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