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Objectives: To understand the implications that the rising upper urinary tract (UUT) stone prevalence in Europe and the increasing burden places on patients and healthcare providers (HCPs), we investigated the evolution of diagnoses and procedures in Germany, France and England over the decade before the coronavirus disease 2019 (COVID‐19) pandemic. Methods: We identified International Classification of Diseases (ICD)‐10 codes related to UUT stones diagnosis and extracted procedure volumes for extracorporeal shockwave lithotripsy (ESWL), ureteroscopy (URS), percutaneous nephrolithotomy and open surgery using national procedure codes from the German Institute for the Hospital Remuneration System, the French Technical Agency of Hospitalisation Information and NHS England Hospital Episode Statistics. We analysed procedures vs hospital diagnoses from 2010 to 2019 and reported results per 100 000 inhabitants. Results: Between 2010 and 2019, ICD‐10 N20 codes for calculus of kidney and ureter increased by 8%, 26% and 15% in Germany, France, and England respectively; whereas procedures increased by 3%, 38% and 18%. Of the patients diagnosed with stones, the percentage that received treatment (of any type) differed between countries. In 2019, in Germany 83% of patients diagnosed with stones received treatment, in France 88%, and in England 56%. These figures were relatively stable over the 10‐year study period. Over the past decade, the dominant procedure shifted from ESWL to URS, and the average length of stay for URS decreased. Day case procedures increased in France and England (by 68% and 23%), no data were available in Germany. Conclusion: This analysis highlights an increase in stone diagnoses and procedures, and a shift of surgical management. This development may be due to clinical advantages and advanced technology. The continued stone prevalence rise affects patients, hospitals, and HCPs. [ABSTRACT FROM AUTHOR]

Objective: To reassess the trends in upper urinary tract (UUT) stone disease burden and management in the UK during the last 5 years. Methods: The present paper is our third quinquennial analysis of trends in the management of renal stones in England. Data were collected using the Hospital Episode Statistics database for the years 2015–2020 inclusive. These were then analysed, summarized and presented. Results: The number of UUT stone episodes increased by 2.2% from 86 742 in 2014–2015 to 88 632 in 2019–2020 but annual prevalence remained static at 0.14%. The number of UUT stone episodes in those of working age has remained static but increased by 9% for patients aged > 60 years (from 27 329 to 29 842). The number of shockwave lithotripsy (SWL) treatments decreased by 6.8%. There was a further increase in the use of ureteroscopy (URS) between 2015 and 2020 of 18.9%. Within this subgroup, flexible URS had the most rapid increase in use, with a rise of 20.4% from 7108 to 8558 recorded cases. Over the 20‐year period from 2000 to 2020 there was a remarkable 257% increase in URS cases. There was a further decline in open surgery for UUT stone disease by 40%. Stone surgery day‐case numbers have increased by 14.7% (from 31 014 to 35 566), with a corresponding decline in the number of bed days of 14.3%. Emergency cases increased by 40%, while elective cases saw a slight increase of 1.9%. Conclusion: The present study shows a plateauing in the prevalence of UUT stone disease in England in the last 5 years, with a move towards day‐case procedures and an increase in the proportion of emergency work. For the first time in England, URS has overtaken SWL as the most common procedure for treating UUT stone disease, which might reflect patients' or physicians' preference for a more effective definitive treatment. [ABSTRACT FROM AUTHOR]

Objective To investigate the postoperative outcomes of percutaneous nephrolithotomy ( PCNL) in English National Health Service ( NHS) hospitals., Patients and Methods We extracted records from the Hospital Episode Statistics ( HES) database for all patients undergoing PCNL between March 2006 and January 2011 in English NHS hospitals., Outcome measures were haemorrhage, infection within the index admission, and rates of emergency readmission and in-hospital mortality within 30 days of surgery., Results A total of 5750 index PCNL procedures were performed in 165 hospitals., During the index admission, haemorrhage was recorded in 81 patients (1.4%), 192 patients (3.8%) had a urinary tract infection ( UTI), 95 patients (1.7%) had fever, and 41 patients (0.7%) had sepsis., There were 595 emergency readmissions in 518 patients (9.0%). Reasons for readmission were varied: 70 (1.2%) with UTI, 15 (0.3%) sepsis, 73 (1.3%) haematuria, 25 (0.4%) haemorrhage, and 25 (0.4%) acute urinary retention., There were 13 (0.2%) in-hospital deaths within 30 days of surgery., Conclusions Haemorrhage and infection represent relatively common and potentially severe complications of PCNL., Mortality is extremely rare after PCNL (about one in 400 procedures overall) but almost one in 10 patients have an unplanned hospital readmission within 30 days of surgery., Complications of PCNL may be under-reported in the HES database and need to be corroborated using other data sources. [ABSTRACT FROM AUTHOR]