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Urol Int. 2019 Sep 10:1-7. doi: 10.1159/000502806. [Epub ahead of print]

Spoilt for Choice: A Survey of Current Practices of Surgical Urinary Stone Treatment and Adherence to Evidence-Based Guidelines among Swiss Urologists.

Author information

1
Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland, Patrick.Betschart@kssg.ch.
2
Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
3
Department of Urology, University Hospital of Lausanne, Lausanne, Switzerland.
4
Department of Urology, Cantonal Hospital Thurgau, Thurgau, Switzerland.
5
Department of Urology, Sindelfingen-Böblingen Medical Centre, University of Tübingen, Sindelfingen, Germany.

Abstract

INTRODUCTION:

Urologists have to master a variety of techniques to be able to offer the most appropriate surgical stone treatment for each individual patient. Therefore, we performed a survey among board-certified Swiss urologists to assess the availability of the different surgical methods, the current practices of surgical treatment of urolithiasis and the adherence to evidence-based guideline recommendations in Switzerland.

METHODS:

A 14-question survey assessed the working environment, equipment, perioperative settings and decision trees for specific stone scenarios. Data was analyzed using descriptive statistics and chi-square tests to determine differences between frequencies of answers.

RESULTS:

Hundred and five members of Swiss Urology (38%) completed the survey. All treatment modalities are available for the majority of respondents. Ureterorenoscopy was found to have the highest availability (100%) and was the preferred choice in the majority of stone scenarios. A high adherence to the guidelines was found for the treatment of ureteral stones <10 mm (100% proximal and distal), and >10 mm (69% proximal, 94% distal). All respondents answered in accordance with the guidelines regarding the treatment of middle and upper pole stones <10 mm, 10-20 mm and lower pole stones 10-20 mm. Guideline adherence was 99% for lower pole stones <10 mm, 78% for lower pole stones >20 mm, and 63% for middle/upper pole stones >20 mm.

CONCLUSION:

This survey provides a detailed insight into current stone treatment practices in Switzerland. The full spectrum of urinary stone treatment options is available for the majority of Swiss urologists. The choice of treatment shows a high accordance with evidence-based guidelines and a preference for retrograde endoscopic surgery in the majority of stone scenarios.

KEYWORDS:

Percutaneous nephrolithotomy; Retrograde intrarenal surgery; Shock-wave lithotripsy; Swiss urology; Treatment; Urinary stone

PMID:
31505510
DOI:
10.1159/000502806

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