Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
Mil Med Res. 2021 Dec 9;8(1):64. doi: 10.1186/s40779-021-00359-8.
BACKGROUND: Urinary tract infections (UTI), urolithiasis, and benign prostatic hyperplasia (BPH) are three of the most common nonmalignant conditions in urology. However, there is still a lack of comprehensive and updated epidemiological data. This study aimed to investigate the disease burden of UTI, urolithiasis, and BPH in 203 countries and territories from 1990 to 2019. METHODS: Data were extracted from the Global Burden of Disease 2019, including incident cases, deaths, disability-adjusted life-years (DALYs) and corresponding age-standardized rate (ASR) from 1990 to 2019. Estimated annual percentage changes (EAPC) were calculated to evaluate the trends of ASR. The associations between disease burden and social development degrees were analyzed using a sociodemographic index (SDI). RESULTS: Compared with 1990, the incident cases of UTI, urolithiasis, and BPH increased by 60.40%, 48.57%, and 105.70% in 2019, respectively. The age-standardized incidence rate (ASIR) of UTI increased (EAPC = 0.08), while urolithiasis (EAPC = - 0.83) and BPH (EAPC = - 0.03) decreased from 1990 to 2019. In 2019, the age-standardized mortality rate (ASMR) of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000, respectively. BPH had the largest increase (110.56%) in DALYs in the past three decades, followed by UTI (68.89%) and urolithiasis (16.95%). The burden of UTI was mainly concentrated in South Asia and Tropical Latin America, while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe. Moreover, the ASIR and SDI of urolithiasis in high-SDI regions from 1990 to 2019 were negatively correlated, while the opposite trend was seen in low-SDI regions. In 2019, the ASIR of UTI in females was 3.59 times that of males, while the ASIR of urolithiasis in males was 1.96 times higher than that in females. The incidence was highest in the 30-34, 55-59, and 65-69 age groups among the UTI, urolithiasis, and BPH groups, respectively. CONCLUSION: Over the past three decades, the disease burden has increased for UTI but decreased for urolithiasis and BPH. The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.
背景：尿路感染（UTI）、尿路结石和良性前列腺增生（BPH）是泌尿外科最常见的三种非恶性疾病。然而，目前仍缺乏全面和最新的流行病学数据。本研究旨在调查 203 个国家和地区 1990 年至 2019 年 UTI、尿路结石和 BPH 的疾病负担。 方法：数据来自 2019 年全球疾病负担研究，包括 1990 年至 2019 年的发病例数、死亡人数、残疾调整生命年（DALYs）和相应的年龄标准化率（ASR）。使用估计年度百分比变化（EAPC）评估 ASR 的趋势。使用社会发展指数（SDI）分析疾病负担与社会发展程度之间的关系。 结果：与 1990 年相比，2019 年 UTI、尿路结石和 BPH 的发病例数分别增加了 60.40%、48.57%和 105.70%。UTI 的年龄标准化发病率（ASIR）增加（EAPC=0.08），而尿路结石（EAPC=-0.83）和 BPH（EAPC=-0.03）的发病率则从 1990 年到 2019 年下降。2019 年，UTI 和尿路结石的年龄标准化死亡率（ASMR）分别为 3.13/100,000 和 0.17/100,000。在过去的三十年中，BPH 的 DALYs 增加最多（110.56%），其次是 UTI（68.89%）和尿路结石（16.95%）。UTI 的负担主要集中在南亚和热带拉丁美洲，而尿路结石和 BPH 的负担则记录在亚洲和东欧。此外，1990 年至 2019 年高 SDI 地区尿路结石的 ASIR 和 SDI 呈负相关，而在低 SDI 地区则呈相反趋势。2019 年，女性 UTI 的 ASIR 是男性的 3.59 倍，而男性尿路结石的 ASIR 是女性的 1.96 倍。UTI、尿路结石和 BPH 组的发病率最高的年龄组分别为 30-34 岁、55-59 岁和 65-69 岁。 结论：在过去的三十年中，UTI 的疾病负担增加，而尿路结石和 BPH 的疾病负担减少。医疗资源的分配应更多地基于疾病的流行病学特征和地理分布。
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