PCNL Use Rises Dramatically in the U.S.
MILAN—Percutaneous nephrolithotomy (PCNL) use is increasing in the United States, according to data presented at the 28th annual congress of the European Association of Urology. The trend was more pronounced among women than men, with women now constituting the majority gender undergoing PCNL, researchers reported.
“We think this operation has become more popular in the U.S., and it's been utilized in a greater range of patients, including older patients and sicker patients,” said investigator Khurshid R. Ghani, MD, a urology fellow at the Vattikuti Urology Institute, Henry Ford Health System, Detroit.
Using the U.S. National Inpatient Sample database, Dr. Ghani and colleagues analyzed data from 80,097 patients who underwent PCNL from 1999-2009. The number of PCNLs per year increased 47%, according to the study, which is the largest to date to assess PCNL use in the U.S. The estimated annual percent change during the study period was significantly greater for women than men (2.54% vs. 0.03%).
The median age of patients increased from 51 years in 1999 to 55 years in 2009. The percentage of patients with one or more co-morbidities increased over time. The proportion of PCNL cases in which complications developed increased significantly from 12.2% in 1999 to 15.6% in 2009. The sepsis rate rose significantly from 1.2% to 2.4%.
The study found that older age, comorbidities, and year of surgery are risk factors for complications.
“Broad utilization of PCNL, especially in older and sicker patients, may account for these changes,” the authors concluded in a poster.
In an interview with Renal & Urology News, Dr. Ghani observed: “Overall, the surgery is being done well in the United States, and continues to be a common operation used by urologists to treat large renal stones.”