title: Current Trends in Urolithiasis Treatment in Various European Health Systems.
abstract: OBJECTIVE
  In spite of readily available evidence-based guidelines on urolithiasis treatment, practical applications of treatments vary from country to country, or even within countries. The choice of treatment depends not only on the evidence, but often on general non-medical decision factors such as infrastructure, expertise, trends, patient demands, industry drive and reimbursement levels. In turn, many of these factors are interdependent and a result of the individual National Health System.
  
  
  METHODS
  In an attempt to get a crude picture of trends and practices in stone treatment across Europe, a group of well-renowned international experts in the field were asked to reply to a set of standard questions relating to stone treatments, health systems and adherence to guidelines (level of evidence D = expert opinion).
  
  
  RESULTS
  The above-mentioned interdependencies showed a varying picture in different countries. Overall, there is a trend away from lithotripsy and toward ureterorenoscopy. However, the choice of treatment is largely dependent on the affordability of infrastructure. Urologists may make choices based on the national reimbursement system, too.
  
  
  CONCLUSIONS
  Without claiming to represent a scientifically sound study, this survey represents an interesting insight into a representative cross-section of European urological current practices and trends in urolithiasis treatment.
authors.affiliation: Harnsteinzetrum, Urologische Klinik Munich-Planegg, Munich, Germany.
authors.forename: Leopold
authors.initials: L
authors.lastname: Durner
authors.forename: Christian
authors.initials: C
authors.lastname: Bach
authors.forename: Mohamed El Fatih
authors.initials: Mel F
authors.lastname: El Howairis
authors.forename: Oliver W
authors.initials: OW
authors.lastname: Hakenberg
authors.forename: Noor
authors.initials: N
authors.lastname: Buchholz
mesh_terms: D005060:Europe; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000639:trends; D006801:Humans; D008096:Lithotripsy / Q000639:trends*; D009313:National Health Programs / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D016896:Treatment Outcome; D018666:Ureteroscopy / Q000639:trends*; D052878:Urolithiasis / Q000175:diagnosis / Q000628:therapy*; D014572:Urology / Q000639:trends*