Percutaneous Nephrolithotomy Use Increasing

PCNL procedure rate nearly doubles over a 2-decade period, study finds.
PCNL procedure rate nearly doubles over a 2-decade period, study finds.

Percutaneous nephrolithotomy (PCNL) procedures nearly doubled in incidence in the United States from 1998 to 2011, according to a new study.

During these 2 decades, the overall annual procedure rate increased from 17 to 31 per million adults, a research team led by Mitchell R. Humphreys, MD, of Mayo Clinic Hospital in Phoenix, concluded in a paper published online ahead of print in Urology.

“This increase has important implications for planning research, developing percutaneous nephrolithotomy technology, and training physicians,” the investigators concluded. “On a larger scale, knowledge of percutaneous nephrolithotomy trends can help tailor stone management to the evolving patient population, one that may require more definitive stone management beyond what is attainable with less-invasive techniques.”

The investigators added that the increasing costs of stone disease management should encourage the use of PCNL as well as boost training and further advances in percutaneous stone treatment. In addition, they noted that PCNL “offers a more definitive surgical treatment and higher stone-free rate compared with other treatment modalities.”

Dr. Humphreys and his colleagues analyzed data from the Nationwide Inpatient Sample and identified 105,180 patients who underwent PCNL from 1998 to 2011. The overall annual procedure rate increased from 17 to 31 per million U.S. adults, with significant increases among white and Hispanic patients. The incidence of PCNL increased from 17 to 30 per million among adult males and 17 to 32 per million among adult females.

The procedure rate increased from 39 to 70 per million adults among individuals aged 18–64 years and from 52 to 113 per million among those older than 65.

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