Work

Surgical management of urolithiasis in france from 2016 to 2022: epidemiological data from the national PMSI database

Year: 2026

Type: article

Abstract: Purpose The incidence of lithiasis is increasing in France; in the general population, the prevalence is close to 10%. The advent of minimally invasive endoscopic techniques has profoundly changed surgical management in recent decades. According to the guidelines, the choice among methods, including Extracorporeal Shock Wave Lithotripsy (ESWL), Ureteroscopy (URS), and Percutaneous Nephrolithotomy (PCNL), remains open. The objective of this study is to describe practices in recent years. Methods Using the French national database of the Program for the Medicalization of Information Systems (PMSI), we collected data from 2016 to 2022 on the number of interventions using the three methods, their distribution by healthcare facility type (public, private, university hospitals), the average length of stay, and the epidemiological characteristics of patients treated for upper urinary tract stones. Results Between 2016 and 2022 in France, the total number of procedures for upper urinary tract stones increased by 12%, with a 37% increase in URS procedures. ESWL procedures decreased by 36%, and PCNL procedures by 5%. The number of procedures steadily increased, except in 2020. The male-to-female sex ratio was close to 2:1, except for PCNL, where it was 1:1. Age profiles are similar across techniques, with a larger proportion of patients aged 51 to 60. 75% of ESWL and 70% of ureteroscopies are performed in private hospitals, 60% of PCNL procedures in public hospitals, and nearly 50% in university hospitals. The average length of stay decreased by 56% for ESWL, 32% for URS, and 22% for PCNL, with the shortest durations in private facilities. Conclusion The total number of procedures for treating upper urinary tract stones has been increasing in France over the years, with a growing proportion of URS procedures at the expense of ESWL and increasingly shorter hospital stays. These results should be compared with medico-economic data to better guide care provision.

Source: World Journal of Urology

DOI: 10.1007/s00345-026-06736-z