Have the technological advancements changed the distribution of treatment modalities for urolithiasis?

Abstract

Objective: The aim of this study was to assess the current practice patterns and the distribution of treatment modalities in treatment of urolithiasis. Material and Methods: A retrospective study was conducted on the patients who underwent procedures for stone removal or fragmentation in 6 centers in İstanbul, between January 1, 2008 and December 31, 2009. Hospital and office charts, operative notes and records, and pertinent radiographic studies of all patients were reviewed. Patient characteristics, treatment modalities, lithotripter use, stone localization and the side were documented for each patient. Results: Of 1756 procedures, the majority was endoscopic surgery (80.7%, n=1417), while 21.6% (n=379) of the patients had percutaneous nephrolithotomy, 47.3% (n=831) had semirigid ureteroscopy, 7.6% (n=134) had cystolithotripsy, 2.2% (n=38) had retrograde intrarenal surgery, 1.4% (n=24) had flexible ureteroscopy, 0.3% (n=6) had laparoscopic ureterolithotomy, and 0.1% (n=2) had laparoscopic pyelolithotomy. Open stone surgery rate was 19.3% (n=339) which included pyelolithotomy (8.5%, n=150), ureterolithotomy (4.7%, n=82), cystolithotomy (2.4%, n=43), nephrolithotomy (2.2%, n=39), pyelonephrolithotomy (0.7%, n=13), anatrophic nephrolithotomy (0.5%, n=8), pyeloplasty (0.3%, n=5) and nephrectomy (0.1%, n=2). There were 1276 (72.7%) males and 480 (27.3%) females between the ages of 3-85 years (mean age 45.5±15.8 years). Conclusion: Although the advent of percutaneous nephrolithotomy and ureteroscopy in combination with lithotripsy technique has dramatically altered the management of renal and ureteral stones, open stone surgery maintains a small but continued role in the treatment of patients with renal and ureteral calculi. © 2014 by Türkiye Klinikleri.