Innovations in Endourologic Stone Surgery: Contemporary Practice Patterns from a Global Survey

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Roman Herout - , Department of Urology, University of British Columbia (Author)
  • Abdulghafour Halawani - , University of British Columbia, King Abdulaziz University (Author)
  • Victor K.F. Wong - , University of British Columbia (Author)
  • Kyo Chul Koo - , University of British Columbia, Yonsei University (Author)
  • Tianshuang Zhong - , University of British Columbia (Author)
  • Alina Reicherz - , University of British Columbia, Ruhr University Bochum (Author)
  • Dirk Lange - , University of British Columbia (Author)
  • Connor M. Forbes - , University of British Columbia (Author)
  • Ben H. Chew - , University of British Columbia (Author)

Abstract

Objective: The purpose of this study is to evaluate the current availability of technology for urolithiasis treatment and ureteroscopy (URS). Perioperative practice patterns, availability of ureteroscopic technologies, pre- and poststenting practices, and methods to alleviate stent-related symptoms (SRS) were assessed via a survey of members of the Endourological Society. Methods: We distributed a 43-question survey online via the Qualtrics platform to members of the Endourological Society. The survey consisted of questions pertaining to the following topics: general (6), equipment (17), preoperative URS (9), intraoperative URS (2), and postoperative URS (9). Results: A total of 191 urologists responded to the survey and 126 completed all questions of the survey (66%). Fifty-one percent (65/127) of urologists were fellowship trained and dedicated an average of 58% of their practice to stone management. In terms of procedures, most urologists performed URS most commonly (68%), followed by percutaneous nephrolithotomy (23%) and extracorporeal shockwave lithotripsy (11%). Ninety percent (120/133) of respondent urologists purchased a new ureteroscope within the last 5 years (16% single-use scopes, 53% reusable, and 31% purchased both). Fifty-three percent (70/132) of the respondents stated that they would be interested in a ureteroscope that can sense intrarenal pressure, with an additional 28% (37/132) stating they would be interested depending on the cost. Seventy-four percent (98/133) of responders purchased a new laser within the last 5 years, and 59% (57/97) changed their lasering technique due to the new laser. Urologists are performing primary ureteroscopy for obstructing stones in 70% of cases, and prefer prestenting patients for subsequent URS in 30% (on average after 21 days). Seventy-one percent (90/126) of responders insert a ureteral stent after uncomplicated URS, which is removed, on average, after 8 days in uncomplicated cases and 21 days after complicated URS. Most urologists give analgesics, alpha-blockers, and anticholinergics for SRS and <10% prescribe opioids. Conclusion: Our survey revealed urologists' eagerness for the early adoption of novel technologies and adherence to conservative practice patterns focused on patient safety.

Details

Original languageEnglish
Pages (from-to)753-760
Number of pages8
JournalJournal of Endourology
Volume37
Issue number7
Publication statusPublished - 1 Jul 2023
Peer-reviewedYes

External IDs

PubMed 37071154

Keywords

ASJC Scopus subject areas

Keywords

  • endourology, laser, technology, ureteroscopy, urinary stents