Evolution of stone management in Australia

Abstract

OBJECTIVE To examine trends in the operative management of upper urinary tract stone disease in Australia over the past 15 years. MATERIALS AND METHODS The Medicare Australia and Australian Institute of Health and Welfare databases were used to determine the annual number of renal colic presentations and procedural interventions undertaken for stone disease. RESULTS In Australia over the past 15 years, the annual number of procedural interventions for upper urinary tract stones has increased, primarily due to the rising number of endoscopic procedures performed. During this period, shock wave lithotripsy numbers have remained steady whilst open and percutaneous procedures have been in decline. CONCLUSION The introduction of and subsequent preference for less invasive techniques has changed the management pathway of patients presenting with stone disease in Australia. Further studies are necessary to determine whether this escalation in endoscopic procedures is due to an increase in the incidence of stone disease, earlier detection, a lower intervention threshold or a higher retreatment rate. © 2011 BJU INTERNATIONAL.