Preoperative Anxiety in Patients Undergoing RIRS and PCNL

Preoperative Anxiety in Patients Undergoing RIRS and PCNL: A Prospective Comparative Study

This prospective observational cohort study aimed to compare preoperative anxiety levels in adult patients undergoing retrograde intrarenal surgery (RIRS) or percutaneous nephrolithotomy (PCNL) for renal stones. The surgical approach was determined according to routine clinical indications and was not assigned by the study protocol. Preoperative anxiety was assessed using the State-Trait Anxiety Inventory-State (STAI-S) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Demographic, clinical, and stone-related characteristics were also recorded to evaluate factors associated with preoperative anxiety.

Adult patients scheduled to undergo RIRS or PCNL for the treatment of renal stones were prospectively enrolled in this single-center observational cohort study. The choice of surgical approach was based on routine clinical assessment, including stone characteristics, anatomical considerations, and the treating urologist's clinical judgment, and was not determined by the research protocol.

Before surgery, participants completed the State-Trait Anxiety Inventory-State (STAI-S) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Demographic characteristics, comorbidities, American Society of Anesthesiologists (ASA) physical status, and stone-related variables were prospectively recorded.

The primary objective was to compare preoperative anxiety levels between patients undergoing RIRS and those undergoing PCNL. The study also evaluated clinical and patient-related factors potentially associated with preoperative anxiety.

Inclusion Criteria:

• Patients over 18 years of age
• Patients scheduled to undergo RIRS or PCNL for renal stones
• Patients scheduled to undergo general anesthesia
• Patients who had not previously undergone general anesthesia

Exclusion Criteria:

• Patients scheduled to undergo spinal anesthesia
• Patients undergoing RIRS or PCNL for ureteral stones
• Patients with a history of general anesthesia
• Patients with psychiatric or neurological disorders
• Patients using anxiolytic or antidepressant medications
• Patients with chronic alcoholism
• Patients with a history of previous stone surgery
• Patients with known congenital renal or urinary tract anomalies