Impact of Percutaneous Nephrostomy on Pain, Quality of Life, Family Burden, and Depressive Symptoms: A Prospective...

To evaluate the impact of percutaneous nephrostomy (PN) on family burden, health-related quality of life (HRQoL), depressive symptoms, and pain, and to identify predictors of postoperative change.

In this prospective study, 119 patients undergoing PN for obstructive uropathy were assessed before and after PN using the Visual Analog Scale (VAS), Beck Depression Inventory (BDI), EQ-5D-3L sum score, and Family Reported Outcome Measure-16 (FROM-16). Pre- and post-procedure differences were analyzed using the Wilcoxon signed-rank test, and multivariable linear regression was used to identify predictors of change (p<0.05).

The mean age was 61.7 years, and 64.7% of the patients were male. Malignancy was the most common etiology, followed by stone disease and benign strictures. All outcomes deteriorated after PN: FROM-16 increased from 7.39 to 15.87, EQ-5D-3L sum score from 7.45 to 13.71, BDI from 12.97 to 17.92, and VAS from 1.22 to 5.23 (all p<0.001). Malignancy, ureteral stricture, and infection were associated with smaller increases in family burden. Spousal caregiving was associated with greater HRQoL deterioration (p=0.020), whereas infection predicted less worsening. Older age was associated with greater increases in BDI, while longer marriage duration and unemployment were associated with smaller BDI changes (p<0.05). Pain worsening was less pronounced in male patients and those with higher education levels (p<0.05).

Although PN relieves obstruction, it is associated with significant deterioration in psychosocial outcomes. Psychosocial screening and caregiver support should be integrated into PN care pathways to protect patient-centered outcomes.