What's known on the subject? and What does the study add? There is very little contemporary data regarding stone management in Australia. This study assesses the impact of technological advances on stone management practises, and raises questions as to why there is an increasing rate of intervention for stone disease in Australia. Knowledge of management trends as demonstrated in this paper give individual surgeons a guideline for contemporary practise in this country. 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.
Objectives To investigate upper urinary tract stone composition rates in Australia To investigate changes in stone composition in Australia over the past 30 years Patients and Methods The Institute for Clinical Pathology and Medical Research (ICPMR) database was used to obtain – stone composition statistics from 2009–2011 Historical comparisons of stone composition rates were obtained from previous Australian studies; Rofe; 1981, and Baker; 1993 for epidemiological data from the 1970s and 1980s respectively. Stone composition data was separated into gender and age‐groups Results From the 791 stones analysed between 2009 and 2011, calcium oxalate remains the dominant type accounting for 64% of stones in our dataset, which compares to 68% from both the 1970s and 1980s. Uric acid stones contributed 16% of contemporary stone compositions, comparable to 16% in the 1970s and 17% in the 1980s. Struvite stones showed a decreasing trend from 14% in the 1970s, to 12% in the 1980s and 7% in the current data. For struvite stones, while the female 21–30 age‐group was the most prolific for struvite stone formation in the 1980s, the peak group in contemporaneous records is 61–70 year‐old men. Conclusion Stone composition in Australia has remained relatively static over the past 30 years. Modifications in diet and body habitus have not resulted in significant changes in the proportion of uric acid and calcium oxalate stones detected. The decreasing trend in the proportion of struvite stones most likely reflects improved management of urinary tract infections within the Australian population.
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