The purpose of our study is to re-assess the trends in upper urinary tract stone (UUTS) disease burden and management in the United Kingdom during the last five years.
The present paper is our third quinquennial analysis of trends in the management of renal stones in England. Data was collected using hospital episode statistics (HES) database for the years 2015-2020 inclusive. It was then analysed, summarized, and presented.
UUTS increased by 2.2% from 86,742 in 2014-15 to 88,632 in 2019-20 but annual prevalence remained static at 0.14%. The number of UUTS episodes in those of a working age has remained static but increased by 9% for patients aged more than 60 (from 27,329 to 29,842).The number of SWL (shockwave lithotripsy) treatments decreased by 6.8%.There was a further increase in the use of URS (ureteroscopy) between 2015-20 of 18.9%. Within this subgroup, flexible ureteroscopy was the most rapid in use with a rise of 20.4% from 7,108 to 8,558 recorded cases. Over the 20-year period from 2000-2020 there was a remarkable 257% increase in URS cases. There was a further decline in open surgery for UUTS by 40%. Stone surgery day case numbers have increased by 14.7% (from 31,014 to 35,566) with a corresponding decline in the number of bed days by 14.3%. Emergency cases increased by 40% while elective cases saw a slight increase of 1.9%.
The present study shows a plateauing in the prevalence of UUTS disease in England in the last five years with a move towards day case procedures and an increase in the proportion of emergency work. For the first time in England, URS has overtaken SWL as the most common procedure for treating UUTS which might reflect patients' or physicians' preference for a more effective definitive treatment.
BJU international. 2022 Mar 20 [Epub ahead of print]
Ibrahim Jour, Angela Lam, Ben Turney
Oxford University Hospitals NHS Foundation Trust, Urology, Old Road, Headington, Oxford, UK, OX3 7LE., Epsom and Saint Helier University Hospitals NHS Trust, PGMC, St Helier Hospital, Wrythe Lane, Carshalton, SM5 1AA, UK., Nuffield Department of Surgical Sciences, University of Oxford, Department of Urology, Oxford, UK.