Rising Upper Urinary Tract (UUT) stone prevalence in Europe is placing and increasing the burden on patients and healthcare providers (HCPs). To understand implications, we investigated the evolution of diagnoses and procedures in Germany, France and England over the decade before the COVID-19 pandemic.
We identified International Classification of Diseases (ICD-10) codes related to UUT stones diagnosis and extracted procedure volumes for Extracorporeal Shock Wave Lithotripsy (ESWL), Ureteroscopy (URS), Percutaneous Nephrolithotomy (PCNL) and Open Surgery (OS) using national procedure codes from German Institute for the Hospital Remuneration System (InEK), the French Technical Agency of Hospitalisation Information (ATIH) and NHS England Hospital Episode Statistics (HES). We analysed procedures versus hospital diagnoses from 2010-2019 and reported results per 100,000 inhabitants.
Between 2010-2019, ICD-10 N20 codes for calculus of kidney and ureter increased by 8%; 26% and 15% in Germany, France and England respectively, whereas procedures increased by 3%; 38% and 18%. Of the patients diagnosed with stones, the percentage that received treatment (of any type) differed between countries. In 2019, in Germany 83% of patients diagnosed with stones received treatment, in France 88% and in England 56%. These figures were relatively stable over the 10 year study period. Over the past decade, the dominant procedure shifted from ESWL to URS, and the average length of stay for URS decreased. Day case procedures increased in France and England (68%;23%), no data was available in Germany.
This analysis highlights an increase in stone diagnoses and procedures and a shift of surgical management. This development may be due to clinical advantages and advanced technology. The continued stone prevalence rise affects patients, hospitals and HCPs.
BJU international. 2023 Mar 30 [Epub ahead of print]
Benjamin W Turney, Clémentine Demaire, Sofie Klöcker, Emily Woodward, Hans-Jörg Sommerfeld, Olivier Traxer
University of Oxford, Oxford-, United Kingdom., Boston Scientific Corporation., Marien-Hospital, Marl-, Germany., Sorbonne University, GRC#20, Lithiase Urinaire, Hôpital Tenon, Paris-, France.