INTRODUCTION - Recent evidence would suggest a low rate of metabolic assessment in stone formers, even in those deemed high risk. We assess the attitudes and practice patterns of metabolic work up in North American members of the Endourological Society as part of the management of stone forming patients.
METHODS - A 12-question online questionnaire was distributed to all members of The Endourological Society via email. Descriptive analyses were performed.
RESULTS - A total of 124 North-American members of the Society responded (90% endourologists, 65% fellowship trained). 97% perform metabolic assessments without referring to a consultant. 83% use a commercial analysis company, 17% request serum or urine parameters individually. 97% believe that 24-48 hour urine collection is a better way of assessing patients for metabolic abnormalities than a 'basic analysis'. Many respondents (37%) would be more likely to metabolically assess if results were easier to interpret, and 35% would like assistance/advice in the interpretation of results. At initial investigation of a first time a stone former, 87% of respondents use serum chemistry, 48% use 24-hour urine, 26% use 48-hour urine, 54% send stone for analysis and 7% do not investigate. On recurrent stone formers 69% use serum chemistry, 73% 24/48 hour urine and 23% send a stone for analysis. The majority agree that pharmacological therapy plays a strong role in preventing recurrence (90%). After initiating pharmacological therapy, 59% reassess using serum chemistry, 84% and 7% use 24-/48-hour urine collection respectively. Physicians re-evaluate patients after 1 month (7%), 1-2 months (10%), 2-4 months (44%), 4-6 months (30%) or after 6-12 months (7%).
CONCLUSIONS - This snap-shot assessment of Endourology Society member's practices in the metabolic investigation of stone forming patients demonstrates wide testing variations. Many physicians expressed interest in assistance/advice in the interpretation of the metabolic assessment results.
Journal of endourology / Endourological Society. 2016 Jan 06 [Epub ahead of print]
Barry B McGuire, Richard S Matulewicz, Rian Zuccarino-Crowe, Robert Nadler, Kent T Perry
Northwestern Memorial Hospital, Urology, Chicago, Illinois, United States, Northwestern Memorial Hospital, Urology, Chicago, Illinois, United States, Northwestern Memorial Hospital, Urology, Chicago, Illinois, United States, Northwestern Memorial Hospital, Urology, Chicago, Illinois, United States. , Northwestern Memorial Hospital, Urology, Chicago, Illinois, United States