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Contemporary Surgical Trends in the Management of Upper Tract Calculi

2014; Lippincott Williams & Wilkins; Volume: 193; Issue: 3 Linguagem: Inglês

10.1016/j.juro.2014.09.006

1527-3792

Daniel T. Oberlin, Andrew S. Flum, Laurie Bachrach, Richard S. Matulewicz, Sarah C. Flury,

Dermatological and Skeletal Disorders

No AccessJournal of UrologyAdult Urology1 Mar 2015Contemporary Surgical Trends in the Management of Upper Tract Calculi Daniel T. Oberlin, Andrew S. Flum, Laurie Bachrach, Richard S. Matulewicz, and Sarah C. Flury Daniel T. OberlinDaniel T. Oberlin , Andrew S. FlumAndrew S. Flum , Laurie BachrachLaurie Bachrach , Richard S. MatulewiczRichard S. Matulewicz , and Sarah C. FlurySarah C. Flury View All Author Informationhttps://doi.org/10.1016/j.juro.2014.09.006AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Upper tract nephrolithiasis is a common surgical condition that is treated with multiple surgical techniques, including shock wave lithotripsy, ureteroscopy and percutaneous nephrolithotomy. We analyzed case logs submitted to the ABU by candidates for initial certification and recertification to help elucidate the trends in management of upper tract urinary calculi. Materials and Methods: Annualized case logs from 2003 to 2012 were analyzed. We used logistic regression models to assess how surgeon specific attributes affected the way that upper tract stones were treated. Cases were identified by the CPT code of the corresponding procedure. Results: A total of 6,620 urologists in 3 certification groups recorded case logs, including 2,275 for initial certification, 2,381 for first recertification and 1,964 for second recertification. A total of 441,162 procedures were logged, of which 54.2% were ureteroscopy, 41.3% were shock wave lithotripsy and 4.5% were percutaneous nephrolithotomy. From 2003 to 2013 there was an increase in ureteroscopy from 40.9% to 59.6% and a corresponding decrease in shock wave lithotripsy from 54% to 36.3%. For new urologists ureteroscopy increased from 47.6% to 70.9% of all stones cases logged and for senior clinicians ureteroscopy increased from 40% to 55%. Endourologists performed a significantly higher proportion of percutaneous nephrolithotomies than nonendourologists (10.6% vs 3.69%, p <0.0001) and a significantly smaller proportion of shock wave lithotripsies (34.2% vs 42.2%, p = 0.001). Conclusions: Junior and senior clinicians showed a dramatic adoption of endoscopic techniques. Treatment of upper tract calculi is an evolving field and provider specific attributes affect how these stones are treated. References 1 : Lower pole I: a prospective randomized trial of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy for lower pole nephrolithiasis-initial results. J Urol2001; 166: 2072. Link, Google Scholar 2 : Expanding role of ureteroscopy and laser lithotripsy for treatment of proximal ureteral and intrarenal calculi. Curr Opin Urol2002; 12: 277. Google Scholar 3 : Temporal trends, practice patterns, and treatment outcomes for infected upper urinary tract stones in the United States. Eur Urol2013; 64: 85. 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Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited bySunaryo P, May P, Holt S, Sorensen M, Sweet R and Harper J (2022) Ureteral Strictures Following Ureteroscopy for Kidney Stone Disease: A Population-based AssessmentJournal of Urology, VOL. 208, NO. 6, (1268-1275), Online publication date: 1-Dec-2022.Johnson B, Sorokin I, Antonelli J and Pearle M (2022) Efficacy of Intramuscular Ketorolac for Preventing Renal Colic Post Stent Removal: Randomized Controlled TrialJournal of Urology, VOL. 208, NO. 3, (650-657), Online publication date: 1-Sep-2022.Ghani K, Rojanasarot S, Cutone B, Bhattacharyya S and Krambeck A (2021) The Economic Burden of Cystoscopy-Based Ureteral Stent Removal in the United States: An Analysis of Nearly 30,000 PatientsUrology Practice, VOL. 9, NO. 1, (40-46), Online publication date: 1-Jan-2022.Bowen D, Song L, Faerber J, Kim J, Scales C and Tasian G (2020) Re-Treatment after Ureteroscopy and Shock Wave Lithotripsy: A Population Based Comparative Effectiveness StudyJournal of Urology, VOL. 203, NO. 6, (1156-1162), Online publication date: 1-Jun-2020.Flynn K, Erickson B, Guidos P, Simmering J, Polgreen P and Tracy C (2019) Longitudinal Assessment of Post-Ureteroscopic Laser Lithotripsy Pain and Opioid Consumption using Text Messaging: Tailoring Pain Management to the PatientUrology Practice, VOL. 6, NO. 6, (369-376), Online publication date: 1-Nov-2019.Ahn J, Holt S, May P and Harper J (2017) National Imaging Trends after Ureteroscopic or Shock Wave Lithotripsy for NephrolithiasisJournal of Urology, VOL. 199, NO. 2, (500-507), Online publication date: 1-Feb-2018.Vilson F, Colaco M, Gutierrez-Aceves J and Terlecki R (2016) Factors Associated with Trial Outcomes in the Management of Nephrolithiasis: A Legal Database ReviewUrology Practice, VOL. 4, NO. 6, (473-478), Online publication date: 1-Nov-2017.Borofsky M, Dauw C, York N, Hoovler C and Lingeman J (2016) Comprehensive Costs Associated with Fiberoptic and Digital Flexible Ureteroscopes at a High Volume Teaching HospitalUrology Practice, VOL. 4, NO. 3, (187-192), Online publication date: 1-May-2017.Monga M (2016) Kidney Stones Destroyed by Shock WavesJournal of Urology, VOL. 197, NO. 2S, (S164-S164), Online publication date: 1-Feb-2017.Gorbachinsky I, Wood K, Colaco M, Hemal S, Mettu J, Mirzazadeh M, Assimos D and Gutierrez-Aćeves J (2016) Evaluation of Renal Function after Percutaneous Nephrolithotomy—Does the Number of Percutaneous Access Tracts Matter?Journal of Urology, VOL. 196, NO. 1, (131-136), Online publication date: 1-Jul-2016.Pearle M (2016) Is Ureteroscopy as Good as We Think?Journal of Urology, VOL. 195, NO. 4 Part 1, (823-824), Online publication date: 1-Apr-2016.Borofsky M, Wollin D, Reddy T, Shah O, Assimos D and Lingeman J (2015) Salvage Percutaneous Nephrolithotomy: Analysis of Outcomes following Initial Treatment FailureJournal of Urology, VOL. 195, NO. 4 Part 1, (977-981), Online publication date: 1-Apr-2016. Volume 193Issue 3March 2015Page: 880-884 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordspercutaneousurolithiasisphysician's practice patternsureteroscopylithotripsynephrostomyMetricsAuthor Information Daniel T. Oberlin More articles by this author Andrew S. Flum More articles by this author Laurie Bachrach More articles by this author Richard S. Matulewicz More articles by this author Sarah C. Flury More articles by this author Expand All Advertisement PDF downloadLoading ...