Quality of life and the associated determinants among adult patients with Urolithiasis attending Muhimbili National Hospital

Abstract

ABSTRACT Introduction: Urolithiasis, a common urinary condition, varies in prevalence globally, from 1% to 20%. Treatment options include extracorporeal shock wave lithotripsy, ureterorenal copy contact lithotripsy, percutaneous nephrolithotomy and open surgical procedure for larger stones. However, the current care approach lacks integration of patient-reported outcomes, alignment with treatment preferences, and resource optimization. Clinical aspects receive more focus in the evidence, while understanding patient quality of life (QoL), disease impact, and treatment effects remains insufficient. Objective: This study aimed at determining the factors that influence the QoL and predictors of QoL among urolithiasis patients undergoing treatment at Muhimbili National Hospital. Methodology: An analytical cross-sectional study involving patients with stone-related issues between October 2023 and March 2024 was carried in Muhimbili National Hospital. Patients completed stone history surveys, SF-36 questionnaire to assess Quality of life. Data were cleaned and analyzed using SPSS version 27. Results: This study included 103 patients meeting inclusion criteria, with a mean age of 47 years (SD = 11.8). Proportion of urolithiasis was 0.67%. Gender distribution was 52.4% male and 47.9% female. The median BMI was 25.7 kg/m2, with 54.4% falling within the normal weight range. Stone-related factors included 85.4% first-time stone formers and 14.6% recurrent formers. Stone sites varied, with 42.7% having stones ≤1cm and 42.7% presenting with hydronephrosis. Analyses revealed no significant differences in renal stone distribution by age or sex (p > 0.05). However, proximal ureteric stones were more prevalent among males (p < 0.05). SF-36 domain scores showed significant differences in role limitations due to emotions and pain between new and recurrent stone formers. Multivariate regression indicated that higher body mass index is associated with lower SF-36 PCS scores (β = -1.198, p = 0.004), highlighting its impact on physical HRQoL. Conclusion: While no significant age or sex differences were found in renal stone distribution, proximal ureteric stones were more prevalent among males. Short form-36 domain scores showed significant disparities in emotional limitations and pain between new and recurrent stone formers, with higher BMI associated with lower physical health related quality of life.