Laparoscopic versus open and shock wave lithotripsy versus ureteroscopy: comparison of outcomes, predictors of success, patient characteristics, and patient experiences

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Ahmed Younis
Amal Obaid
Enas Al-Naser
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Background: Urinary tract stone, also known as urolithiasis, is a very common health problem encountered in the practice of urology and has 6 main types with multiple stone compositions. This study has targeted the ureteric stone type among the main 6 types, and was divided into two phases; phase one being the cross-sectional part of the research aimed to study ureteric stone patients ageing between 3-84 years old, the second phase is a qualitative study assessing patients’ experiences and satisfaction regarding health care services. Methodology: Data collection was accessed by the Medical Record Administrator of An-Najah National University and the data collected was extracted in an Excel sheet, and a semi-structured in-depth unified interview script was used; interviews conducted in this study were guided by an interview schedule; the interviewees were recruited using a judgmental sampling technique; this sampling approach ensured reaching out to the interviewees, diversifying the recruited sample, and the data collected from the interviews; interviews were conducted in one-on-one sessions and the interviewer possessed previous experience in conducting qualitative studies. Results: Prevalence of ureteric stone was 74.8%, 25.2% for males and females respectively. The distribution of the stone site was as follow; right ureteric stone (38.5%), Left ureteric stone (43.4%) and bilateral ureteric stone (8.4%). Patients ≥43 years old were found to be more likely to have comorbidity (p=0.001). Patients with benign prostatic hyperplasia in this sample study account for 9.1% of the cases (p=0.038). Regarding the thematic analysis adopted for this study, four major themes emerged from the collected data that addressed the objectives of this study. These themes were as follows: hospital staff, patient care and treatment, information on leaving hospital and the overall impression; the total interviews conducted were twenty; ten interviews with patients that underwent ureteroscopy for stone removal and the other ten who did extracorporeal shock wave lithotripsy (ESWL). Conclusion: The cross-sectional study has shown the prevalence of ureteric stone among both sexes within wide range of ages, which in turn had an association with other predictors like comorbidity, as well as its relation with BUN and Cr levels. On the other hand, the explorative qualitative study showed perspectives of different patients on services that could be used as quality indicator of healthcare facilities. Quality indicators are extremely useful for informing decisions relevant to improving evidence-based practice and increase patents satisfaction regarding healthcare services. Further studies are still needed to assess patents expectations and perceptions of satisfied healthcare services.