Urolithiasis Treatment in Australia: The Age of Ureteroscopic Intervention

Perera, Marlon; Papa, Nathan; Kinnear, Ned; Wetherell, David; Lawrentschuk, Nathan; Webb, David R.; Bolton, Damien

doi:10.1089/end.2016.0513

Cited by 35 publications

(40 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent literature reports that URS is on the rise and is being performed more commonly than PCNL [19]. In our study PCNL was the most common procedure performed, this may be because of our institute being a tertiary care referral center for the region.…”

Section: Discussionmentioning

confidence: 73%

Unplanned 30-day readmission rates in patients undergoing endo-urological surgeries for upper urinary tract calculi

et al. 2018

View full text Add to dashboard Cite

PurposeTo see the 30-day unplanned readmission rates in patients underdoing endo-urological surgeries for upper urinary tract calculi we conducted this retrospective study at King George's Medical University, Lucknow, India. Unplanned readmissions not only add to healthcare costs but also are bothersome for the patients. There are many studies on 30-day unplanned readmissions in general surgical patients. Although similar studies have been done in certain urological procedures, no study has reported readmission rates or its risk factors in patients undergoing surgeries for upper urinary tract calculi.Materials and MethodsWe retrospectively reviewed our prospectively maintained database from 1st January 2009 to 31st December 2017, for the patients who underwent endo-urological procedures for upper urinary tract calculi and identified the patients who were re-admitted within 30 days of discharge.ResultsOut of the total 3,209 patients undergoing endo-urological procedures for upper urinary tract calculi 56 were re-admitted. The readmission rate was 1.74% over the study period. The most common etiology for readmission was sepsis followed by hematuria. The significant risk factors for readmission in bivariate analysis included male gender, age >65 years, current smoking, chronic obstructive pulmonary disease, diabetes mellitus, bleeding disorder, prior cardiac disease, and American Society of Anesthesiologists (ASA) class ≥3. In multivariate risk adjusted logistic regression analysis ASA class ≥3 was the only independent risk factor for readmission.ConclusionsThe readmission rates in endo-urological procedures for urolithiasis are less compared to other procedures. ASA class ≥3 is the most important independent predictor of unplanned 30-day readmissions.

show abstract

Section: Discussionmentioning

confidence: 73%

Unplanned 30-day readmission rates in patients undergoing endo-urological surgeries for upper urinary tract calculi

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Since its introduction in the early 1980s, ureterorenoscopy (URS) has been used in the treatment of urolithiasis [1]. URS is the main active stone removal procedure in many countries, and in some places, such as Australia, it is used in > 70% of all cases [2].…”

Section: Introductionmentioning

confidence: 99%

A Stent for Every Stone? Prestenting Habits and Outcomes from a German Multicenter Prospective Study on the Benchmarks of Ureteroroscopic Stone Treatment (BUSTER)

et al. 2020

View full text Add to dashboard Cite

Introduction: Previous studies have shown that prestenting in ureterorenoscopic stone removal (URS) is carried out more frequently in Germany than in other countries. Objective: This investigation evaluated the impact of high prestenting rates on outcomes as well as the influence of stone characteristics and treatment habits on prestenting. Methods: The dataset from the BUSTER observational study was used. Patient and stone characteristics, as well as treatment outcomes, were analyzed for 307 cases from 14 urological clinics in Germany. Results: The overall prestenting rate was 70.0%. Prestenting rates were significantly higher for renal stones than ureteric stones (84.6 vs. 60.6%, p < 0.0001). Compared to the unstented cases, prestenting for renal stones improved stone-free rates (73.2 vs. 11.1%, p < 0.0001) and increased the rate of completely lesion-free URS (45.4 vs. 16.7%, p = 0.034) while reducing the rate of poststenting (from 100 to 80.8%, p = 0.041). None of these effects could be demonstrated when prestenting for ureteric stones. Prestenting rates were less variable for renal stones (57-100%) than for ureteric stones (0-100%, p < 0.01). Conclusions: This study confirms the benefits of prestenting in URS for renal stones but not for ureteric stones. There were considerable differences in prestenting rates between the participating clinics.

show abstract

“…Causes of urethral stricture include infection, instrumentation, radiation, surgery, trauma and lichen sclerosus, but ~30% are idiopathic . Important contributors to an expected growth in stricture prevalence are instrumentation attributable to the increasing use of endoscopic methods for treatment of urolithiasis and large‐volume BPH, and treatment for prostate cancer in the context of an ageing population with greater comorbidity . One tertiary centre reported that urethral stricture comprised 7.7% of urological radiotherapy complications, leading to acute admission .…”

Section: Discussionmentioning

confidence: 99%

“…The burden of disease from urethral strictures is expected to increase with time. Contributory factors include a rising incidence of prostate cancer in an ageing population, with use of radiotherapy and increasing utilisation of endoscopic vs open urological procedures for large‐volume BPH and urolithiasis .…”

Section: Introductionmentioning

confidence: 99%

Trends in urethral stricture management over two decades

2019

View full text Add to dashboard Cite

Objectives To identify trends in the management of urethral stricture disease in Australia, assess changes in the standard of care, and examine the availability of genitourinary reconstructive surgery. Methods Data on eight stricture management procedures were collected online via Medicare Item Reports from the Australian Government Department of Human Services, and then matched to population data from the Australian Bureau of Statistics. A survey was disseminated via the Urological Society of Australia and New Zealand (USANZ) asking whether active members performed urethroplasty and whether this was done in a rural, regional or metropolitan setting. Results Over a 22‐year period, there were 140 540 endoscopic procedures and 5136 urethroplasties, with 27.4 endoscopic procedures per urethroplasty. From 1994 to 2016, the per capita number of passage of sounds and dilatation procedures decreased by 74% and 75%, respectively, with increases in use of optical urethrotomy of 70% and in single‐stage urethroplasty of 144%. Overall, the ratio of all endoscopic procedures vs urethroplasty decreased from 58.9 to 16.8. There were as few as 16 surgeons in the USANZ performing urethroplasty, with seven providing this service in regional areas. Seven had formal fellowship training. Conclusion There has been a clear shift from repetitive endoscopic procedures towards urethroplasty, but the former still make up the majority of interventions. This may be explained by patients not being referred for urethroplasty earlier in the course of disease and there appears to be a gap in genitourinary reconstructive expertise in regional and rural areas.

show abstract

Urolithiasis Treatment in Australia: The Age of Ureteroscopic Intervention

Cited by 35 publications

References 23 publications

Unplanned 30-day readmission rates in patients undergoing endo-urological surgeries for upper urinary tract calculi

Unplanned 30-day readmission rates in patients undergoing endo-urological surgeries for upper urinary tract calculi

A Stent for Every Stone? Prestenting Habits and Outcomes from a German Multicenter Prospective Study on the Benchmarks of Ureteroroscopic Stone Treatment (BUSTER)

Trends in urethral stricture management over two decades

Contact Info

Product

Resources

About