title: Practice patterns in the treatment of large renal stones.
abstract: OBJECTIVE
  To determine the current practice patterns of a large group of urologists in the treatment of large renal stones.
  
  
  METHODS
  A survey was sent to all actively practicing members of the North Central Section of the American Urological Association. The questions pertained to age, time in practice, type of practice, time devoted to treating stones, residency training, case scenarios with treatment options, and whether they or a radiologist performed percutaneous access. The data were statistically analyzed.
  
  
  RESULTS
  The response rate was 51% (564/1102 surveys returned). Three quarters (73%) of the urologists were comfortable performing percutaneous nephrolithotomy (PCNL), and 35% gave reasons they do not perform PCNL. Only 11% of those performing PCNL routinely obtained the percutaneous access themselves. Trends in the analysis included: (1) those trained to perform PCNL during residency were more often comfortable with this procedure; (2) younger urologists were more comfortable performing PCNL, even if they had been in practice for only a short time; (3) urologists in private practice were nearly as comfortable performing PCNL as were academic urologists; (4) urologists not comfortable with PCNL more often recommended SWL over PCNL as a primary treatment for moderate/large renal stones; and (5) few urologists routinely obtained percutaneous access themselves.
  
  
  CONCLUSIONS
  Many urologists trained in recent years are comfortable performing PCNL. The type of training received influences treatment recommendations, and percutaneous access is most often obtained by/in conjunction with radiologists. This information may be useful in guiding residency training programs in the preparation of residents for the treatment of large renal stones.
authors.affiliation: Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA. vbird@med.miami.edu
authors.forename: Vincent G
authors.initials: VG
authors.lastname: Bird
authors.forename: Bernard
authors.initials: B
authors.lastname: Fallon
authors.forename: Howard N
authors.initials: HN
authors.lastname: Winfield
mesh_terms: D000328:Adult; D017677:Age Distribution; D001363:Awards and Prizes; D004522:Educational Status; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008096:Lithotripsy / Q000706:statistics & numerical data; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014481:United States; D018666:Ureteroscopy / Q000706:statistics & numerical data; D013520:Urologic Surgical Procedures / Q000706:statistics & numerical data*; D014572:Urology / Q000193:education / Q000706:statistics & numerical data*