Post‐operative recovery of quality‐of‐life following percutaneous nephrolithotomy: The impact on pain intensity and interference and the ability to participate in social roles

Objectives To prospectively capture patient‐reported outcomes in the post‐operative period to better understand the quality‐of‐life impact of percutaneous nephrolithotomy (PNL). Subjects and Methods Adults undergoing PNL for renal/ureteral stones were eligible for inclusion (11/2020–8/2022). Patients prospectively completed PROMIS – Pain Intensity, Pain Interference and Ability to participate in social roles and activities in‐person pre‐operatively (POD 0) and via email on POD 1, 7, 14 and 30. Scores are reported as T‐scores (normalized to US pop., mean = 50) with a change of 5 (0.5 SD) considered clinically significant. Results A total of 62 participants enrolled at POD 0 (POD 1 = 28, POD 7 = 29, POD 14 = 20, POD 30 = 23). There was a worsening of quality of life from POD 0 to POD 1 for pain intensity (median difference 7.9, p = 0.005) and pain interference (median difference 11.9, p = 0.0003), but not for the ability to participate in social roles (median difference −5.3, p = 0.07). This was also observed for POD 0 to POD 7, but only for the dimension of pain interference (median difference 7.2, p = 0.02). All three dimensions then improved until POD 30. In multivariable analysis, there were no variables associated with severe symptomatology for any of the three dimensions. Conclusions Pain intensity and interference sharply increase immediately post‐operatively, reducing quality of life, although the ability to participate in social roles is not impacted. The absolute magnitude of this change is significant, with a final improvement at 30 days at or above baseline. Results offer meaningful insight to assist in setting expectations for patients post‐operatively.