Department of Urology, University of California San Diego Health, San Diego, CA, USA.
University of California San Diego School of Medicine, San Diego, CA, USA.
Eur Urol Focus. 2017 Feb;3(1):18-26. doi: 10.1016/j.euf.2017.04.001. Epub 2017 Apr 24.
The recent evolution of management options for urolithiasis has presented a unique dilemma for the modern urologist. A comprehensive understanding of epidemiological trends along with current provider preferences in treating urinary stones would be beneficial.
To review trends in the prevalence, treatments, and costs of urolithiasis worldwide.
A literature review was performed using the MEDLINE database, the Cochrane Library Central search facility, Web of Science, and Google Scholar between 1986 and 2016. Keywords used for the search were "urolithiasis" and "prevalence; treatment; and cost".
The incidence and prevalence of urinary stones are rising around the world, including regions that have historically had low rates of urolithiasis. Common theories explaining this trend involve climate warming, dietary changes, and obesity. Shockwave lithotripsy (SWL) has been the preferred mode of treatment since its introduction in the 1980s. However, ureteroscopy (URS) has become increasingly popular for small stones regardless of location because of lower recurrence rates and costs. Developing countries have been slower to adopt URS technology and continue to use percutaneous nephrolithotomy at a steady rate.
URS has recently challenged SWL as the treatment modality preferred for small upper urinary tract stones. In some cases it is less expensive but still highly effective. As the burden of stone disease increases worldwide, appropriate selection of stone removal therapies will continue to play an important role and will thus require further investigation.
Urinary stones are becoming more prevalent. Recent advances in technology have improved the management of this disease and have decreased costs.
尿路结石治疗选择的最新进展给现代泌尿科医生带来了独特的困境。全面了解结石流行病学趋势以及当前治疗尿路结石的医生偏好将非常有益。
综述全球范围内尿路结石的流行率、治疗方法和费用变化趋势。
使用 MEDLINE 数据库、Cochrane 图书馆中央搜索工具、Web of Science 和 Google Scholar 对 1986 年至 2016 年间发表的文献进行了回顾。检索关键词包括“尿路结石”和“流行率；治疗；费用”。
世界各地尿路结石的发病率和流行率都在上升，包括历史上结石发病率较低的地区。解释这一趋势的常见理论包括气候变暖、饮食变化和肥胖。自 20 世纪 80 年代冲击波碎石术（SWL）问世以来，它一直是首选的治疗方法。然而，由于复发率和费用较低，输尿管镜检查（URS）已成为治疗任何部位小结石越来越受欢迎的方法。发展中国家采用 URS 技术的速度较慢，仍在稳定地使用经皮肾镜取石术。
URS 最近已挑战 SWL 成为治疗小上尿路结石的首选方法。在某些情况下，它的费用更低，但仍然非常有效。随着全球结石病负担的增加，选择适当的结石清除疗法将继续发挥重要作用，因此需要进一步研究。
尿路结石越来越普遍。技术的进步改善了这种疾病的管理，降低了成本。
