MP41-07 TRENDS IN UROLOGICAL INTERVENTION FOR RENAL STONE DISEASE IN ENGLAND: EVIDENCE FROM HOSPITAL EPISODES STATISTICS (HES) DATABASE

Abstract

You have accessJournal of UrologyStone Disease: Medical Therapy1 Apr 2015MP41-07 TRENDS IN UROLOGICAL INTERVENTION FOR RENAL STONE DISEASE IN ENGLAND: EVIDENCE FROM HOSPITAL EPISODES STATISTICS (HES) DATABASE Bhaskar Kumar Somani, Ed Chegdy, and Ghulam Nabi Bhaskar Kumar SomaniBhaskar Kumar Somani More articles by this author , Ed ChegdyEd Chegdy More articles by this author , and Ghulam NabiGhulam Nabi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1635AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Treatment of urological stone disease has evolved in the last decade with the advent and popularity of minimally invasive percutaneous and endoscopic techniques and miniaturization of scopes. With an increase in the incidence of stone disease and cost associated with it, knowing the trends in urological stone disease and its intervention will help us plan our services, train juniors and in ongoing and new research. METHODS The hospital episodes statistics (HES) database was devised in 1987 and contains all NHS activity (diagnosis and intervention) in England whereby data is collected and coded for all patients via the local hospital information systems and the number of episodes are recorded as finished consultant episodes (FCE). To capture the trends in the incidence of urolithiasis and its intervention by shock wave lithotripsy (SWL), ureteroscopy (URS), percutaneous stone surgery (PCNL) and open surgery we analyzed data for the last 6 years from 2007-2013. While we looked at the overall trend, we compared annual data from 2007-2008 (period-1) to 2012-2013 (period-2). RESULTS Total number of FCE for ‘Urolithiasis' increased by 12.5% from 79,199 (period-1) to 89,035 (period-2). A total of 224,454 renal/ureteric stone related procedures were done in NHS England during this 6-year period and included 376 (0.16%) open stone procedures, 9,625 (4%) PCNL procedures, 76,110 (33%) URS and 132,085 (59%) SWL procedures. During this 6-year period the total number of SWL procedures increased by 15%(from 19,386 in period-1 to 22,477 in period-2) but this rise was mainly due to a 20% rise in the reporting of renal SWL with a 6% fall in ureteric SWL. There was a 64% rise (from 9,551 in period-1 to 15,667 in period-2) in the total number of URS procedures during the two periods, with a 96% rise in kidney URS and a 51% rise in the ureteric URS procedure. Although the overall proportion of emergency ureteroscopy procedure was similar in the 2 time periods (12-13%), there was a 64% rise in the total numbers of elective URS procedures in period-2. While there was a 39% fall in the reporting of open stone surgery, there was a 43% rise in the number of PCNL type procedures. CONCLUSIONS There is a consistent trend for greater intervention for renal stone disease for all minimally invasive stone treatments, especially for ureteroscopy. Although it does reflect an increase in prevalence of stone disease, the real reason for this might reflect a better training, equipment availability and surgical expertise in modern day minimally invasive techniques. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e502 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bhaskar Kumar Somani More articles by this author Ed Chegdy More articles by this author Ghulam Nabi More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...