Patient Preference for Management of an Asymptomatic 15 mm Renal Calculus-Avoid Risk or Maximize Success?

Area of Science:

• Nephrology
• Urology
• Patient-centered care

Background:

• Asymptomatic 15 mm renal stones present management challenges.
• Patient preferences significantly influence treatment decisions.

Purpose of the Study:

• To evaluate patient preferences for managing asymptomatic 15 mm renal stones.
• To identify factors influencing patient decision-making among treatment options.

Main Methods:

• A survey assessed 103 patients' choices among extracorporeal shock wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy.
• Patients considered provided success rates, risks, and morbidity for each procedure.
• Statistical analysis used Fisher exact and Wilcoxon signed rank tests.

Main Results:

• Ureteroscopy was preferred by 56% of patients, followed by percutaneous nephrolithotomy (25%) and shock wave lithotripsy (19%).
• Shock wave lithotripsy preference correlated with prioritizing minimal risk (74%).
• Percutaneous nephrolithotomy preference correlated with prioritizing high success rates (81%).
• Ureteroscopy patients valued both success and risk moderately.

Conclusions:

• Patient choices for renal stone treatment are driven by distinct priorities: success maximization (percutaneous nephrolithotomy) or risk minimization (shock wave lithotripsy).
• Ureteroscopy represents a balanced choice for many patients.
• Understanding these decision-making factors aids urologists in patient counseling and expectation management.