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Turney BW et al, 2011: Trends in urological stone disease

Turney BW, Reynard JM, Noble JG, Keoghane SR
Oxford Stone Group, Department of Urology, Nuffield Department of Surgical Sciences, The Churchill Hospital, Oxford, Department of Urology, Queen Alexandra Hospital, Portsmouth, UK


Abstract

Study Type - Therapy (case series) Level of Evidence
What's known on the subject? and What does the study add?

• Urolithiasis is a major clinical and economic burden for health care systems.

• International epidemiological data suggest that the incidence and prevalence of stone disease is increasing. This study demonstrates that the number of diagnoses and procedures relating to kidney stone disease has increased significantly in the last 10 years in the UK. Management of stone disease comprises a significant and increasing proportion of urological practice in the UK, which has implications for work force planning, training, service delivery and research in this field.

OBJECTIVE: To summarize the changes in prevalence and treatment of upper urinary tract stone disease in the UK over the last 10 years.

METHODS: Data from the Hospital Episode Statistics (HES) website (http://www.hesonline.nhs.uk) were extracted, summarized and presented.

RESULTS:

• The number of upper urinary tract stone hospital episodes increased by 63% to 83050 in the 10-year period.

• The use of shock wave lithotripsy (SWL) for treating all upper tract stones increased from 14491 cases in 2000-2001 to 22402 cases in 2010 (a 55% increase) with a 69% increase in lithotripsy for renal stones.

• There was a 127% increase in the number of ureteroscopic stone treatments from 6283 to 14242 cases over the 10-year period with a 49% increase from 2007/2008 to 2009/2010.

• There was a decline in open surgery for upper tract stones from 278 cases in 2000/2001 to 47 cases in 2009/2010 (an 83% reduction).

•  Treatment for stone disease has increased substantially in comparison with other urological activity. In 2009/2010, SWL was performed almost as frequently as transurethral resection of the prostate or transurethral resection of bladder tumour, ureteroscopy for stones was performed more frequently than nephrectomy, radical prostatectomy and cystectomy combined, and percutaneous nephrolithotomy was performed more frequently than cystectomy.

CONCLUSIONS:

• The present study highlights the increase in prevalence and treatment of stone disease in the UK over the last 10 years.

• If this trend continues it has important implications for workforce planning, training, service delivery and research in the field of urolithiasis.

© 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.
BJU Int. 2012 Apr;109(7):1082-7. doi: 10.1111/j.1464-410X.2011.10495.x. Epub 2011 Aug 26
PMID: 21883851 [PubMed - as supplied by publisher]

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Comments 1

Hans-Göran Tiselius on Wednesday, 10 August 2011 14:57

This is an epidemiological report from UK, showing that there was an increased prevalence of stones in the population during the period 2000-2010. It is assumed that the increased prevalence is explained by the increasingly common metabolic syndrome – a world-wide problem.

The use of both ESWL and URS had increased during the same period of time. Interestingly there was increased use of ESWL for stones located in the kidney and apparently an increased use of URS for ureteral stones. The fact that ESWL is more commonly applied in the treatment of stones in the kidney seems to differ from findings in some other epidemiological reports. It was speculated that the different choice of treatment modalities for stones in the kidneys and ureters was an insufficient access to the rapid lithotripter service required for appropriate treatment of ureteral stones.

Hans-Göran Tiselius

This is an epidemiological report from UK, showing that there was an increased prevalence of stones in the population during the period 2000-2010. It is assumed that the increased prevalence is explained by the increasingly common metabolic syndrome – a world-wide problem. The use of both ESWL and URS had increased during the same period of time. Interestingly there was increased use of ESWL for stones located in the kidney and apparently an increased use of URS for ureteral stones. The fact that ESWL is more commonly applied in the treatment of stones in the kidney seems to differ from findings in some other epidemiological reports. It was speculated that the different choice of treatment modalities for stones in the kidneys and ureters was an insufficient access to the rapid lithotripter service required for appropriate treatment of ureteral stones. Hans-Göran Tiselius
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