How do the residual fragments after SWL affect the health-related quality of life? A critical analysis in a size-based manner

This study aimed at evaluating the possible effects of residual fragments (RF) after shockwave lithotripsy (SWL) on the health-related quality of life (QOL) of the patients on a size-related basis. Eighty six patients with RF after SWL were divided into three groups: Group 1 (n:30 with fragments ≤2 mm), Group 2 (n:21 2–≤4 mm) and Group 3 (n:35 > 4 mm). During a 3-month follow-up, spontaneous passage rates, emergency department visits, mean analgesic required, additional procedures and the QOL were all evaluated. QOL was evaluated using the Short Form-36 survey. Of the 30 patients with fragments ≤2 mm all cases passed the fragments spontaneously. Of the 21 cases with fragments 2–≤4, however, 76 % were stone free. Last, of the 35 cases with fragments >4 mm, 52 % passed them spontaneously in 3 months. While no patient with fragments ≤2 mm required emergency department visit, 19 % of the cases with fragments 2–≤4 mm and 51.4 % with fragments >4 mm did require this visit. Mean analgesic need (mg) values were higher in cases with larger fragments. Evaluation of the QOL score data in a subgroup comparison base showed that cases with larger fragments had prominently lower scores during both 1- and 3-month evaluation. RF after SWL could pose an impact on the QOL of the cases in a size-related basis. While fragments ≤2 mm had nearly no impact on this aspect larger fragments could significantly affect the QOL.