The Trend Change of Incidence and Treatment of Urolithiasis between the 1980s and 2000s

Ha Na Lee; Ha Na Yoon; Bong Suk Shim

doi:10.4111/kju.2007.48.1.40

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

Original Article

Korean J Urol 2006;48(1):40-44.

Published online: 18 December 2006

DOI: https://doi.org/10.4111/kju.2007.48.1.40

The Trend Change of Incidence and Treatment of Urolithiasis between the 1980s and 2000s

Ha Na Lee, Ha Na Yoon, Bong Suk Shim

¹From the Department of Urology College of Medicine, Ewha Womans University, Seoul, Korea

Corresponding Author: Shim Bong-seok Department of Urology, Ewha Womans University Dongdaemun Hospital 70, Jongno 6-ga, Jongno-gu, Seoul ? 110-783 TEL: 02-760-5136 FAX: 02-3672-0953 E-mail: bonstone@ ewha.ac.kr

Received 5 July 2006 Accepted 17 September 2006

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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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Keywords: Urolithiasis, Trends, Treatment

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Fig. 1.

Comparison of the age distribution of the numbers suffering from urolithiasis according to the period.

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Fig. 2.

Comparison of the seasonal distribution of the numbers suffering from urolithiasis according to the period.

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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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