Heers H et al, 2016: Trends in urological stone disease: a 5-year update of Hospital Episode statistics.
Heers H, Turney BW.
Department of Urology, Oxford University Hospitals, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
OBJECTIVE: To provide a 5-year follow-on update on the changes in prevalence and treatment of upper urinary tract stone disease in the UK.
METHODS: Data from the Hospital Episode Statistics (HES) website (w w w hesonline . nhs . uk ) were extracted, summarized, analysed and presented.
RESULTS: The total number of upper urinary tract stone hospital episodes increased slightly from 83,050 in 2009-10 to 86,742 in 2014-15 (4.4% increase). The use of shock wave lithotripsy (SWL) for treating all upper tract stones remained stable over the 5-year study period following a significant increase in previous years. There was a 49.6% increase in the number of ureteroscopic stone treatments from 12,062 in 2009-10 to 18,055 in 2014-15. Increase in ureterorenoscopy (flexible ureteroscopy) demonstrated the most rapid increase from 3267 to 6631 cases in the 5-year study period (103% increase). The gap between the total number of ureteroscopies and SWL treatments continues to narrow. Open stone surgery continued to decline with only 30 reported cases in 2014-15. Due to the continued rapid increase in the number of ureteroscopies performed, treatment for stone disease has continued to increase significantly in comparison to other urological activity.
CONCLUSION: This study provides an update on the changing landscape of the management of urinary tract stones in the UK. It demonstrates a sustained high prevalence of stone disease in the UK commensurate with levels in other developed countries. This study reveals a trend in the last 5 years to surgically intervene on a higher proportion of patients with stones. As in other countries, there is a significant increase in the use of ureteroscopy (particularly intrarenal flexible ureteroscopy) in the UK. These data have important implications for work-force planning, training, service delivery and research in the field of urolithiasis. This article is protected by copyright. All rights reserved.
BJU Int. 2016 Apr 29. doi: 10.1111/bju.13520. [Epub ahead of print]
Another important publication concerning the socioeconomic position of ESWL and the way it starts losing its impact among the urological armamentarium. “If the current trends continue, it would be expected that the number of flexible ureteroscopies will surpass the number of SWL treatments in 3 years’ time. It will be interesting to see if SWL continues to be used to treat as many renal stones in the coming years.”