الفهرس 
AcknowledgementsOnly 14 pages are availabe for public view
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Abstract
Urolithiasis is a common and serious problem in urology clinics after UTI and prostate disease. Currently, most cases of renal stones have been managed with SWL and PNL. Thus, ORSS for the treatment of renal stones have become rare and PNL has become the treatment of choice for large or complex stones. However, for complex renal stones, the use of SWL or endoscopic treatments may require multiple endourological procedures to achieve stone free status compared with single session ORSS. Only a few studies have investigated HRQoL in patients undergoing lithotripsy for urinary
stones. Patients with urinary stones represent a good group for the investigation of HRQoL owing to specific features of this disease, such as its high prevalence, peak incidence in a socially active generation, severe symptoms and high recurrence rate. This study evaluates the HRQoL in patients undergoing renal stone treatment using the short form-36 items questionnaire and to investigate the factors that extensively impact HRQoL in these patients. This study aimed to: 1. To evaluate the effect of renal stone treatment on HRQoL. 2. To detect factors affecting HRQoL after different method of renal stone treatment. 3. To compare the results of SWL, PNL and open renal surgery for treatment of renal stones as regard HRQoL The study was conducted in the Urology and Nephrology, SWL unit and outpatient clinic at Asyut University Hospital. Data were collected from 222 adult patients undergoing SWL, PNL and ORSS and follow up was be done after three month. Seventy five patients from each group of treatment are included in this study. The following tools were utilized for data collection: Tool I: Patient assessment sheet (Annex A). Part I: Socio-demographic characteristics Part II: Medical data. Part III: Operative and post operative data.
Part VI: Clavien-Dindo grading system for the classification of surgical complications. Tool II: Rand short form 36 items questionnaire (Annex B). 12 Statistical design: Data was collected and analyzed by computer programmed SPSS (version 17). Using
number, percentage, mean, chi-square and T test. Statistical significance was considered at Pvalue 0.05. Main findings of the present study were as the following: There was significant difference between stone clearance immediately postoperative and three month after surgery in all PNL and SWL patients. The presence of internal indwelling ureteral stent affects HRQoL negatively in patients with renal stones. There was significant difference between physical function, emotional role limitation, mental health, physical role limitation, social function and pain as regarding performance status. There was highly significant difference between all eight domains in the short form 36 questionnaire as regarding preoperative and postoperative QoL for patients with SWL, PNL and ORSS. Quality of life for patients treated by PNL was found to be significantly higher than the rest of patients regarding all domains except emotional role limitation. There was highly significant difference between postoperative physical function, postoperative physical role limitation, vitality, social function, mental health, pain and general health as regarding stone free.