Journal List > Korean J Urol > v.48(1) > 1004897

Lee, Yoon, and Shim: The Trend Change of Incidence and Treatment of Urolithiasis between the 1980s and 2000s

Abstract

Purpose:

The incidence of urolithiasis has recently shown an increasing tendency in relation to improvements in living conditions in Korea. With the development of extracorporeal shock wave lithotriptor (ESWL), endo- urology and other new instruments, urolithiasis has become easier to treat, without surgical intervention. The incidence and treatment of urolithiasis, between the 1980 and 2000, were evaluated.

Materials and Methods:

328 and 1,142 patients with urolithiasis, either admitted between January 1981 and December 1984 or treated at the out-patient clinic between January 2001 and December 2004, respectively, were analyzed.

Results:

In the early 1980s, 328 (27.3%) patients of the total 1,203 admitted to the urology department had urolithiasis. In the early 2000s, 1,142 patients were treated for urolithiasis. The total number and incidence constantly increased over the stated period. The ratio of males to females was 1.3:1 in the 1980s and 2.0:1 in the 2000s. The occurrence rate for those under 20 years decreased, but increased after the 6th decade. And the seasonal occurrence was highest during the summer of the early 1980s, but there was no seasonal difference during the early 2000s. The incidences of lower ureteral, bladder and urethral calculi were decreased, but those of renal and upper ureteral calculi increased. In the management of urolithiasis, open surgery and expectant therapy decreased during the 2000s. In the endourological management of urolithiasis, the success rates of ESWL, percutaneous nephrolithotomy (PNL) and ureteroscopic removal of stone (URS) were 94.5, 86.6 and 96.4%, respectively.

Conclusions:

The incidence and treatment modalities of urolithiasis have changed, especially since the late 1980s. (Korean J Urol 2007;48:40-44)

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Fig. 1.
Comparison of the age distribution of the numbers suffering from urolithiasis according to the period.
kju-48-40f1.tif
Fig. 2.
Comparison of the seasonal distribution of the numbers suffering from urolithiasis according to the period.
kju-48-40f2.tif
Table 1.
Comparison of the yearly distribution of the numbers suffering from urolithiasis according to sex and period
  Year Male Female Total
1980s 1981 32 29 61
1982 41 35 76
1983 54 41 95
1984 57 39 96
Annual average 46 36 82.0
2000s 2001 163 90 253
2002 188 93 281
2003 189 98 287
2004 226 95 321
Annual average 191.5 94 285.5
Table 2.
Location of calculi according to the period
Stone location 1980s(%) 2000s(%)
Kidney 54 (16.5) 439 (38.4)
Ureter 251 (76.5) 668 (58.5)
  Upper 65 (19.8) 304 (26.6)
  Mid 12 (3.7) 24 (2.1)
  Lower 174 (53.0) 340 (29.8)
Bladder 19 (5.8) 33 (2.9)
Urethra 4 (1.2) 2 (0.2)
Total 328 (100) 1,142 (100)
Table 3.
Comparison of therapeutic procedures according to the period
Treatment 1980s (%) 2000s(%)
Nephrectomy 11 (3.4) 4 (0.4)
Nephrolithotomy 4(1.2) 7 (0.6)
Pyelolithotomy 25 (7.6) 1 (0.1)
Ureterolithotomy 75 (22.9) 18 (1.6)
Cystolithotomy 10 (3.0) 6 (0.5)
Lithorapaxy 6(1.8) 25 (2.2)
Urethrolithotomy 2 (0.6) 0
Dormia dislodger 62 (18.9) 0
Ureteroscopy 0 248 (21.7)
PNL 0 8 (0.7)
ESWL 0 672 (58.8)
Expectant therapy 133 (40.5) 153 (13.4)
Total 328 (100) 1,142 (100)

PNL: percutaneous nephrolithotomy, ESWL: extracorporeal shock wave lithotripsy

Table 4.
Success rates of endourological procedures for urolithiasis
Treatment No. of success/ No. of total cases (%)
Extracorporeal shock wave lithotripsy 635/672 (94.5)
Percutaneous nephrolithotomy 7/8 (87.5)
Ureteroscopic removal of stone 239/248 (96.4)
Dormia dislodger apply∗ 42/62 (67.7)
Total 923/990 (93.2)

∗application only in 1980s

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