Department of Urology, Marien Hospital Herne, Ruhr-University of Bochum, Hölkeskampring 40, 44625, Herne, Germany.
Department of Urology, University Carl Gustav Carus, Dresden, Germany.
World J Urol. 2022 Jan;40(1):237-242. doi: 10.1007/s00345-021-03813-3. Epub 2021 Aug 18.
Urinary stone disease is a common disease with a prevalence of 4.7% in Germany. The incidence increased over the last decades, and recurrence rates are up to 50% in the first 5 years after diagnosis. Adequate preventive measures can avoid up to 46% of stone recurrences. These numbers outline the importance of prevention. Especially among high-risk stone formers, specific diagnostics and measures are required. Published data indicate the divergence between the importance of prevention and its implementation in everyday clinical practice. This is the first survey among German urological departments highlighting medical care concerning the prevention of recurrent urinary stone disease, identifying challenges and providing recommendations for improvements.
Two hundred and seventy urological hospital departments in Germany were anonymously surveyed about measurements to prevent recurrent stone disease. The questionnaire comprised 23 items dealing with diagnostics, counselling, knowledge among doctors concerning preventive measures and difficulties in preventing recurrent urinary stone disease.
Sixty-three urological departments (23.8%) answered the survey. The majority perform stone analysis at first and repeat events. Most patients with urinary stone disease receive general advice on preventive measures during their hospitalization. General recommendations focus on fluid intake and lifestyle changes. However, specific diets are infrequently recommended by inpatient urologists. Diagnostics to identify high-risk stone formers are mostly insufficient, and guideline-compliant urine tests are uncommon.
The quality of secondary prevention needs to improve considerably. The focus should be put on identifying high-risk stone formers and offering those patients specific counselling. Furthermore, general advice on dietary recommendations should be extended.
尿路结石病是一种常见疾病，在德国的患病率为 4.7%。在过去几十年中，其发病率有所上升，在诊断后的头 5 年内，复发率高达 50%。适当的预防措施可以避免高达 46%的结石复发。这些数字突出了预防的重要性。特别是在高危结石形成者中，需要进行特定的诊断和措施。已发表的数据表明，预防的重要性与其在日常临床实践中的实施之间存在差距。这是首次对德国泌尿科部门进行的调查，重点介绍了预防复发性尿路结石病的医疗保健情况，确定了挑战，并提出了改进建议。
对德国 270 家泌尿科医院部门进行了匿名调查，了解预防复发性结石病的措施。问卷包括 23 个项目，涉及诊断、咨询、医生对预防措施的了解以及预防复发性尿路结石病的困难。
63 个泌尿科部门（23.8%）回答了调查。大多数部门首次进行结石分析并重复检查。大多数尿路结石病患者在住院期间接受预防措施的一般建议。一般建议侧重于液体摄入和生活方式的改变。然而，住院泌尿科医生很少推荐特定的饮食。识别高危结石形成者的诊断大多不足，符合指南的尿液检查也不常见。
二级预防的质量需要大大提高。重点应放在识别高危结石形成者并为这些患者提供特定的咨询上。此外，应扩大关于饮食建议的一般建议。
