Comparative Study of Mental Stress Score between Various Surgical Modalities for Treatment of 10–20 mm Renal Calculi
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 5, Issue 11
Abstract
Introduction: The treatment of renal calculi has undergone a paradigm change in the past two decades. The ultimate aim in treating these stones will be to achieve a complete clearance with minimal morbidity. The risk of recurrence or incomplete clearance or need for ancillary procedures would significantly affect patients’ mental health. Purpose: The purpose of this study is to compare mental stress experienced by the patient on the completion of the treatment using Kessler Psychological Distress Scale (K10) for each modality in the management of renal and upper ureteric calculi 10–20 mm size. Materials and Methods: This was a prospective study on patients with renal calculi. Following the procedure, patients were asked to fill up and complete the questionnaire at 2 and 6 weeks. The K10 questionnaire contained 10 questions with each of them having 5 outcomes. Based on the total score, the degrees of mental distress due to the procedure were graded as mild, moderate, and severe. Results: When assessing patients’ psychological status using Kessler’s scale at 2 weeks, a majority of patients had a score of <20. However, one-fifth of patients in the retrograde intrarenal surgery group and about one-sixth of patients in percutaneous nephrolithotomy (PCNL) group had a mild distress score. When assessing patients’ psychological status using Kessler’s scale at 6 weeks following primary procedure, most patients are <20 score, and hence, not statistically significant. But when the Shock wave lithotripsy (SWL) group was analyzed, 2.5% of patients had a significant psychological stress. Conclusion: All three procedures have a good acceptance rate among the patients. PCNL, though more invasive than the other two procedures, has a better acceptance rate in view of achieving complete clearance in one sitting. On the other hand, extracorporeal SWL (ESWL), despite being so non-invasive, has a significant psychological impact in view of the need for multiple sittings and associated complications.
Authors and Affiliations
Velmurugan Palaniyandi, Siddharth Munisamy, Sriram Krishnamoorthy, Venkat Ramanan, Natarajan Kumaresan
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