Item Level Analysis of Patient-Reported Outcomes After Ureteroscopy for Kidney Stones-Plan Your Chores, Cancel Your...

To examine item-level changes in PROMIS pain interference and ability to participate in social roles and activities following ureteroscopy (URS).

A prospective cohort study was conducted at a single academic center from 2020 to 2022. Adults undergoing URS for nephrolithiasis completed the PROMIS pain interference (computer-adaptive test, 15 subdomains) and ability to participate in social roles and activities (short-form 8a, 8 subdomains) at baseline and at postoperative days (POD) 1, 7, 14, and 30. The primary outcome was a minimal clinically important difference (≥5 points) in T-score from baseline to POD 1. Pairwise comparisons were assessed for change from baseline to each POD using linear mixed-effects models.

A total of 178 participants were enrolled. For pain interference, only 2 of 15 items-work around the home and day-to-day activities-demonstrated a statistically and clinically significant worsening at POD 1 (change +5.9 and +5.7, respectively; both P <.01), persisting through POD 7 before recovering by POD 30. In contrast, 6 of 8 social participation items worsened significantly at POD 1 (change -5.2 to -6.8 points; all P <.01), with full recovery by POD 30.

URS produces a specific, task-limited impact on pain interference but a comprehensive reduction in social participation both in and outside the home. These item-level findings offer actionable targets for patient counseling and anticipatory guidance prior to surgery.