Document Detail

Factors influencing urologist treatment preference in surgical management of stone disease.
MedLine Citation:
PMID:  22245295     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the surgeon factors influencing the surgical treatment decisions for symptomatic stone disease. The factors influencing the selection of shock wave lithotripsy (SWL), ureteroscopy, or percutaneous nephrolithotomy to treat symptomatic stone disease are not well studied.
METHODS: Electronic surveys were sent to urologists with American Medical Association membership. Information on training, practice, and ideal treatment of common stone scenarios was obtained and statistically analyzed.
RESULTS: In November 2009, 600 surveys were sent and 180 were completed. High-volume SWL practices (>100 cases annually) were more common in community practice (P < .01), and high-volume ureteroscopy and percutaneous nephrolithotomy practices were more common in academic practice (P = .03). Community practice was associated with SWL selection for proximal urolithiasis and upper pole nephrolithiasis (P < .005). An increasing time since urologic training was associated with SWL selection for proximal urolithiasis and upper pole nephrolithiasis (P < .01). Urologists reporting shock wave lithotriptor ownership were 3-4 times more likely to select SWL for urolithiasis or nephrolithiasis compared with urologists who did not own a lithotripter (P < .01). Routine concern for stent pain and rigid ureteroscope preference (vs flexible) were associated with SWL selection (P < .03).
CONCLUSION: Surgeon factors significantly affected urolithiasis treatment selection. SWL was associated with community urology practice, increasing time since training, shock wave lithotriptor ownership, concern for stent pain, and ureteroscope preference.
M Adam Childs; Laureano J Rangel; James E Lingeman; Amy E Krambeck
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-01-13
Journal Detail:
Title:  Urology     Volume:  79     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-01     Completed Date:  2012-07-02     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  996-1003     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Department of Urology, Mayo Clinic, Rochester, Minnesota 55905, USA.
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MeSH Terms
Academic Medical Centers / statistics & numerical data
Community Health Services / statistics & numerical data*
Data Collection
Lithotripsy / utilization
Middle Aged
Nephrolithiasis / therapy
Nephrostomy, Percutaneous / utilization
Ownership / statistics & numerical data
Pain / etiology
Physician's Practice Patterns / statistics & numerical data*
Stents / adverse effects
Time Factors
United States
Ureteroscopy / utilization
Urolithiasis / therapy*
Urology / education,  statistics & numerical data*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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