Surveys in endourology over time: what are the urologist preferences? A trend review over a 24-year period (2000-2024).

INTRODUCTION

Surveys are a powerful tool to investigate practice patterns and preferences among health care practitioners. This narrative review aims to analyse the trends of publications on surveys related to endourological procedures in the new millennium, to highlight changes and preferences in urologists' practice of urolithiasis.

MATERIAL AND METHODS

A literature search was conducted in Google Scholar and PubMed focusing on English language surveys published between 2000 and 2024 (24 years). The SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) framework was used to frame and answer the question (S: urology practice; P: senior or training urologists; I: surveys since 2000 C: none; E: pathways in the management of urolithiasis). The studies were divided into two 12-year periods: period 1 (2000-2011) and period 2 (2012-2024). The studied procedures were related to the management of stone disease including ureteroscopy (URS), percutaneous nephrolithotomy (PCNL), and shockwave lithotripsy (SWL).

RESULTS

Over a 24-year timeframe, 27 surveys were selected on the subject, with a relative increase from period one to period two (23.7%). Notably, the technique experiencing significant growth was URS, with just one survey published in the initial period compared to 11 in the subsequent period and a decrease toward less utilisation of SWL. The surveys showed that urologists are moving towards minimisation of both PCNL and URS, with greater use of access sheath and lasers for fragmentation, although variations in practice patterns are observed worldwide, especially related to the use and duration of both pre- and post-operative stent insertions. Most surveys suggest that the majority of urologists follow international guidelines during their clinical practice.

CONCLUSIONS

Endourology surveys have experienced steady growth in publications. Instrumentation trends emphasise miniaturisation, stent indications, laser types, and disposable ureteroscopes. Recently, there has been a focus on endourological training, imaging, ergonomics, and guidelines to enhance patient and surgical outcomes.