Podium Session 2: Endourology

Saturday June 25, 2022 from 08:00 to 09:00

Room: Bedeque & Cardigan

POD-2.1 Characterizing symptomatic patients with small non-obstructing renal calculi (SNORC): a primary prospective cohort study analysis

Abstract

Characterizing symptomatic patients with small non-obstructing renal calculi (SNORC): A primary prospective cohort study analysis

David Chapman1,4, Suhyeon Park1, Saifee Rashiq1,2, Bruce Dick2, Stacey Broomfield3, Timothy Wollin1,3,4, Trevor Schuler1,3,4, Shubhadip De1,2,3.

1Faculty of Medicine, University of Alberta, Edmonton, AB, Canada; 2Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada; 3Alberta Center for Urologic Research and Excellence, Edmonton, AB, Canada; 4Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada

Introduction: As little data exists on the nature and causes of pain in non-obstructing renal stones, our objective was to assess how disease-specific factors, global patient characteristics, and personality traits influence perceived symptoms.

Methods: After consent was obtained, patients completed a standardized history, physical exam, and questionnaire sets. Enrollment was 2:1 asymptomatic patients (AP) to symptomatic patients (SP) with computed tomography-confirmed calyceal stones ≤5 mm, without focal signs of obstruction. Descriptive statistics and Student’s t-tests were used to characterize and compare groups. 

Results: Our primary analysis included 28 patients (8 SP, 20 AP). There were no significant differences in age, gender, household income, or prevalence of functional pain syndromes (i.e., 25% vs. 27% IBS, FM, IC, etc.). All (100%) SP had prior stone events (vs. 55% of AP). More AP endorsed chronic neck or back pain (25% vs. 12.5%), whereas SP reported worsened pain with physical activity (50% vs. 30%) and used more daily pain medication (62.5% vs 25%). Standardized assessment tools for pain and psychometric contributors showed SP have significantly higher Body Pain Index (12.2 vs. 43.3, p=0.005), and Pain Disability Index scores (5.9 vs. 23.8, p=0.004). SP also scored higher on catastrophizing (15.2 vs. 31.7, p=0.008), and kinesiophobia inventories (29.5 vs. 40.3, p=0.014). No significant differences were noted in the Modified Somatic Perception Questionnaire, or Hospital Anxiety and Depression Scale. The Wisconsin Stone QoL tool did not differ between groups, however, the more generalized 15D QoL tool showed a decreased overall health-related quality of life in SP (20.3 vs. 26.8, p=0.05). 

Conclusions: Our preliminary analysis of the SNORC cohort identifies potential psychometric contributors to symptomatic complaints related to stone disease. Future studies based on these findings will attempt to further define this challenging population.



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