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unknown, we look at the outcomes of stone management
in this group.
Material and Methods: Over a period of 6-years (March
2012-December 2017), we identified all patients with
prior urosepsis and emergency drainage who underwent
elective URS for stone treatment. They were seen in a
dedicated pre-assessment clinic with antibiotics as per
protocol or microbiologist.
Results: A total of 76 patients underwent 82 procedures
(6 bilateral URS) with a male: female ratio of 1:2 and a
mean age of 75 years (range 14-86 years). Urosepsis was
diagnosed on admission with 27 (36%) admitted to ICU
and a positive urine culture in 26 (34%). The mean WBC
count and CRP was 14.3 (2.7-42) and 199 (1-425) respectively. Emergency drainage was achieved via ureteric stent
(63, 83%) and nephrostomy (13, 17%).
The mean single and overall stone size was 8.6 mm (2-23
mm) and 10.8 mm (2-32 mm) respectively with 45 ureteric stones (59%), 17 ureteric and renal stones (22%)
and 14 with multiple stones in the urinary tract (19%).
With a mean operating time of 42 minutes (5-129 minutes), the stone free rate (SFR) was 97%, and 60 (79%)
were discharged within same day. Three patients (4%)
developed complications (urosepsis), two Clavien II that
needed intravenous antibiotics and one Clavien IV that
needed ICU admission and treatment, subsequently discharged home.
Conclusion: Planned elective ureteroscopy in patients
with prior urosepsis and emergency drainage achieves an
excellent outcome with good SFR and low complication
rates.
P4-8 Urinary stones and intervention quality
of life (USIQOL): Development of a new
comprehensive patient reported outcome
measure
Joshi H1, Raja A2, Teleb H1, Bratt D2, Bolomytis S3,
Philip J3, Biyani C2, Wood F4
1University Hospital of Wales, Cardiff, United Kingdom, 2St. James
University Hospital, Leeds, United Kingdom, 3Soutmead Hospital and
BUI, Bristol, United Kingdom, 4Cardiff University, United Kingdom

Introduction: Urolithiasis and treatments can have significant impact on patients' health-related quality of life
(HRQoL). We developed Urinary stones and Intervention
quality of Life (USIQoL), a new multidimensional PROM.
Methods: Adult patients with urinary stones covering all
index stone categories were asked to participate in different phases (over 350 patients). Phase 1 included literature
review and qualitative research that formed the foundation for the initial long draft of the USIQoL. Phase 2
included cognitive debriefing, pilot testing. Phase 3 involved
RASCH analysis (partial credit model) and validity and
reliability assessments to develop the final draft.

Journal of Clinical Urology 11(1S)
Results: Mean patient age was 51 years (range 18-92)
with male patient predominance. Phase 1 studies involved
80 patients and 30 family members. The results identified
significant negative QoL impact affecting pain, physical and
psycho-social domains along with concerns, specific to
stones and treatments. The thematic analyses formed the
basis for the initial 60 item draft. Phase 2 confirmed content validity with all stakeholders. In phase 3 the RASCH
polytomous analysis identified redundant items and
helped develop final version with good item, personal fit
and satisfactory separation index. The measure covers all
relevant domains of stone and intervention specific factors. The validation studies showed questionnaire to be
internally consistent (Cronebach's alpha>0.7) and reliable
(Pearson coefficient>0.8) with satisfactory sensitivity to
change (p<0.01).
Conclusion: The new USIQoL is a comprehensive valid
PROM developed using rigorous standards in measurement studies. It is expected to serve as a standard PROM
to evaluate impact of stone disease and treatments.
P4-9 Outcomes of ureteroscopy (URS) for
kidney stone disease (KSD) in patients with
spinal cord injury (SCI)
Oliver R1, New F1, Davies M1, Brewin J1
1Salisbury NHS Foundation Trust, United Kingdom

Introduction: The management of KSD in SCI patients is
complex. Minimal data is available regarding treatment
outcomes in this cohort with URS. We present the largest
UK series of URS in SCI patients.
Patients and Methods: A retrospective analysis was
made of all SCI patients undergoing URS and laser lithotripsy between 2005-17 at our supra-regional spinal injuries unit.
Results: A total of 41 procedures were performed in 21
patients with a mean age of 49 years (range 17-69) and a male:
female ratio of 6:1. Almost a quarter had undergone previous
urinary tract reconstruction. Mean total stone length was
27mm (range 5-59mm) with the majority of stones in the
kidney (97%). Eleven patients (27%) had a pre-operative
stent and access was achieved in 98%. An access sheath
was used in 26 cases (63%) and a post-operative stent was
required in 11 (27%). Mean length of stay was 2 days
(median 1; range 0-9). Complications occurred in 10 cases
(24%), which were all Clavien-Dindo grade II. Residual
fragments were noted in 16 cases (42%). Stone recurrence
occurred in 16 cases (42%); 4 within 12 months (10.5%)
and 12 after a year (31.6%). Further intervention within
a year was required in 11 cases (27%) excluding 7 planned
multi-stage procedures. The stone-free rate at 12 months
was 47%.
Conclusion: SCI patients undergoing URS for KSD have
lower stone-free rates than other reported series and a



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