@Article{,
AUTHOR = {Stephan Seklehner, Melissa A. Laudano, Joseph Del Pizzo, 
Bilal Chughtai, Richard K. Lee},
TITLE = {Renal calculi: trends in the utilization of shockwave lithotripsy and ureteroscopy},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {22},
YEAR = {2015},
NUMBER = {1},
PAGES = {7627--7634},
URL = {http://www.techscience.com/CJU/v22n1/61302},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> To assess trends in the usage of 
extracorporeal shockwave lithotripsy (SWL) and 
ureteroscopy (URS) in the treatment of renal calculi.<br/>
<b>Materials and methods:</b> An analysis of the 5% 
Medicare Public Use Files (years 2001, 2004, 2007 and 
2010) was performed to evaluate changes in the use 
of SWL and URS to treat renal calculi. Patients were 
identified using ICD-9 (cm) and CPT codes. <br/>
Statistical analyses, including the Fisher, χ2 tests, and 
multivariate logistic regression analysis were performed 
using SAS 9.3 (SAS Institute Inc., Cary, NC, USA) and 
SPSS v20 (IBM Corp., Armonk, NY, USA).<br/>
<b>Results: </b>The absolute number of patients diagnosed with 
(+85.1%) and treated for (+31.5%) kidney calculi increased 
from 2001 to 2010. The ratio of diagnosed/treated patients 
declined from 15.2% in 2001 to 10.8% in 2010. Whites 
(OR = 1.27, p < 0.0001), patients in the South (OR = 1.16, 
p < 0.0001) and those ≤ 84 years of age were more likely to 
be treated. The utilization of SWL (84.7%) was greater 
than URS (15.3%), but the utilization of URS increased 
over time from 8.4% in 2001 to 20.6% of cases by 2010 
(p < 0.0001). Treatment via URS was more likely in women 
(OR = 1.28, p < 0.0001), in patients living outside the 
South (OR = 1.29-1.45, p ≤ 0.006) and in later years of 
the study (OR = 2.87, p < 0.0001). <br/>
<b>Conclusions: </b>Treatment patterns for renal calculi 
changed from 2001 to 2010. The usage of URS increased 
at the cost of SWL. Multiple sociodemographic factors 
correlated with the likelihood of being treated surgically 
as well as the choice of the surgical approach.},
DOI = {}
}