Current scenario of endourological treatment of kidney stones in brazil: results of a national survey

Abstract

Objective: To elucidate the current scenario of endourology in Brazil for the treatment of urinary lithiasis, with an emphasis on regional differences and the reasons why certain techniques are still underutilized. Materials and Methods: An electronic questionnaire was sent by email to the 4,745 members of the Brazilian Urological Society (BSU) in 2016 to collect information on the 3 main endourological procedures used in the treatment of nephrolithiasis: Semi-rigid ureteroscopy (URS), Flexible ureteroscopy (F-URS) and percutaneous nephrolithotripsy (PCNL). Results: A total of 1,267 urologists answered the questionnaire. It was observed that the vast majority perform URS (95.6%), while 80.2% perform FURS and only 72.1% perform PCNL. Regarding the surgical volume, most perform up to 10 procedures per month (73.4% to 88.2%) and the main impediment was the lack of patients with the pathology (42.1% to 67.7%). The lack of equipment or hospital infrastructure was one of the main limiting factors for rigid (23%) and fl exible (38.1%) URS, mainly in the North and Northeast regions of the country. Regarding PCNL, most of them reported lack of practical experience in the method (29.9%). Finally, most urologists expressed interest in taking courses in endourology. Conclusion: Ureteroscopy, rigid or fl exible, is already well established in the country, requiring the direction of more resources for its practice, especially in less developed regions. Regarding PCNL a signifi cant part of Brazilian urologists still lack practical experience in this procedure, emphasizing the need for greater investment in teaching this technique.

Editorial Comment: Objective Assessment and Standard Setting for Basic Flexible Ureterorenoscopy Skills Among Urology Trainees Using Simulation-Based Methods

“…Flexible ureterorenoscopy (fURS) is a frequent procedure in urology practice (1). Graduating residents are expected to be competent in the skills necessary to perform fURS.…”

Correlation of the S.T.O.N.E. Score with surgical outcomes of Percutaneous Nephrolithotomy in an academic hospital

“…Urinary lithiasis (UL) is one of the most frequent urological diseases, resulting in significant cost to the public health system, and compromising affected individuals' quality of life 1 . Its global prevalence has increased over the years between 2 to 20%, depending on the geographic region.…”