title: Trends in urological stone disease: a 5-year update of hospital episode statistics.
abstract: OBJECTIVE
  To provide a 5-year follow-on update on the changes in prevalence and treatment of upper urinary tract (UUT) stone disease in England.
  
  
  METHODS
  Data from the Hospital Episode Statistics (HES) website (http://www.hesonline.nhs.uk) were extracted, summarised, analysed, and presented.
  
  
  RESULTS
  The total number of UUT stone hospital episodes increased slightly from 83 050 in 2009-2010 to 86 742 in 2014-2015 (4.4% increase). The use of shockwave lithotripsy (SWL) for treating all UUT stones remained stable over the 5-year study period following a significant increase in previous years. There was a 49.6% increase in the number of ureteroscopic stone treatments from 12 062 in 2009-2010 to 18 055 in 2014-2015. Increase in ureterorenoscopy (flexible ureteroscopy) showed the most rapid increase from 3 267 to 6 631 cases in the 5-year study period (103% increase). The gap between the total number of ureteroscopies and SWL treatments continues to narrow. Open stone surgery continued to decline with only 30 reported cases in 2014-2015. Due to the continued rapid increase in the number of ureteroscopies performed, treatment for stone disease has continued to increase significantly in comparison to other urological activity.
  
  
  CONCLUSIONS
  This study provides an update on the changing landscape of the management of UUT stones in England. It shows a sustained high prevalence of stone disease commensurate with levels in other developed countries. This study reveals a trend in the last 5 years to surgically intervene on a higher proportion of patients with stones. As in other countries, there is a significant increase in the use of ureteroscopy (particularly intrarenal flexible ureteroscopy) in England. These data have important implications for work-force planning, training, service delivery, and research in the field of urolithiasis.
authors.affiliation: Department of Urology, Oxford University Hospitals, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK. hendrik.heers@nds.ox.ac.uk.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Heers
authors.affiliation: Department of Urology, Oxford University Hospitals, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Turney
mesh_terms: D000293:Adolescent; D000328:Adult; D004739:England / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D007669:Kidney Calculi / Q000453:epidemiology* / Q000628:therapy*; D008875:Middle Aged; D015995:Prevalence; D013997:Time Factors; D014514:Ureteral Calculi / Q000453:epidemiology* / Q000628:therapy*; D055815:Young Adult
keywords: endourology; epidemiology; kidney stones; public health; urolithiasis