Medicare population based studies have recently shown the use of ureteroscopy (URS) for the treatment of urolithiasis has been increasing in the ambulatory setting (1). Despite this, population-based studies comparing the use of URS with shock wave lithotripsy (SWL) are lacking (2).
We sought to describe the current trends of the utilization of URS and SWL in ambulatory surgery centers in the state of California utilizing the State of California Office of Statewide Health Planning and Development database over five-year period.
This study demonstrated the use of URS increased significantly from 6,978 (39%) cases in 2005 to 9,259 (49%) cases in 2010 (p<0.0012), whereas the use of SWL decreased from 10,853 (61%) cases in 2005 to 9,674 (51%) cases in 2010 (p=0.0012) (Figure 1). This finding underpins a major shift in practice patterns for the treatment of urolithiasis for the state of California and confirms similar trends in North America reported by Ordon et al (3).
To conclude, this study suggests the use of URS has increased significantly in the state of California. Future studies guiding the management of upper urinary stones will require geographically broader datasets, aiming to establish practice patterns in the ambulatory setting across the United States.
Figure 1. Ambulatory stone surgeries over time from 2005 to 2010, OSHPD.
References:
1. Scales CD Jr, Krupski TL, Curtis LH, et al. Practice variation in the surgical management of urinary lithiasis. J Urol. 2011; 186:146-50.
2. Ghani KR, Sammon JD, Karakiewicz PI, et al. Trends in surgery for upper urinary tract calculi in the USA using the Nationwide Inpatient Sample: 1999-2009. BJU Int. 2013; 112:224-30.
3.Ordon M, Urbach D, Mamdani M, et al. The surgical management of kidney stone disease: a population based time series analysis. J Urol. 2014; 192:1450-6.
Written by:
Omer A. Raheem, MD, MSc Ana, MCh Urol, MRCS and Roger L. Sur, MD
Department of Urology, University of California San Diego Health Care System, San Diego, California, USA.
Abstract: Contemporary Trends in the Ambulatory Surgical Treatment of Urolithiasis: Population Based Analysis