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Management behaviors of the urology practitioners to the small lower calyceal stones: the results of a web-based survey

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Abstract

Lower pole calyceal stones (LPS) represent lower spontaneous passage rates and, therefore, require several interventional treatment approaches. The aim of this survey study was to investigate the attitudes of the urology practitioners and the factors affecting their decision making in the management of small asymptomatic LPS. A total of 149 urologists participated to the study via email through the internet-based website. Participating urologists were asked to complete a 29-question survey including personal and academic data, level of surgical experience, available equipment for interventional approaches, which treatment do they prefer for small LPS (≥5 mm and <1 cm), and factors affecting their treatment decision. All data were analyzed to make inferences related with treatment decision and factors affecting decision-making. Mean participant age was 41.57 (26–62) years. The most preferred approach was observation/medical treatment option (52.3 %), subsequently SWL (25.5 %), RIRS (16.1 %), miniPNL (5.4 %) and standard PNL (0.7 %) were chosen by the participants. On the other side, SWL and medical treatment were at the forefront (52 and 16.1 %) among children. In the multivariate analysis of participants’ age, academic status, surgical experience and institution, none was significantly associated with treatment decision-making (p > 0.05). The most important factors associated with decision making were calyceal dilatation (85.9 %) and patient preferences (81.2 %). The other factors effecting treatment decision were reported to be recurrent disease (70.5 %), the duration of the stone (74.5 %), patient age (95.3 %), current guidelines (87.9 %), stone density (50.3 %), body mass index (BMI) (73.8 %) and other morbid diseases (91.9 %). Our surveys’ greatest value is in demonstrating the preferred treatment options and factors effecting decision-making in the treatment of LPS. The most preferred option in our population was follow-up and medical treatment. The most influencing factors on decision-making were age, patients’ preferences, presence of calyceal dilatation, body mass index, comorbid conditions, available options for stone treatment and the surgeon’s experience on the existing opportunities.

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Authors and Affiliations

  1. Department of Urology, GMMA Haydarpasa Research and Training Hospital, Uskudar, Istanbul, Turkey

    Ferhat Ates, Murat Zor, Omer Yılmaz & Temucin Senkul

  2. Urology Department, Kartal Research and Training Hospital, Istanbul, Turkey

    Murat Tuncer, Bilal Eryildirim, Fehmi Narter & Kemal Sarica

  3. Urology Department, Haydarpasa Research and Training Hospital, Istanbul, Turkey

    Metin Ozturk & Orhan Koca

  4. Urology Department, Medeniyet University, Istanbul, Turkey

    Cenk Gurbuz, Gokhan Atis & Asif Yildirim

  5. Urology Department, Umraniye Research and Training Hospital, Istanbul, Turkey

    Eyup Veli Kucuk

Authors
  1. Ferhat Ates
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  2. Murat Zor
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  3. Omer Yılmaz
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  4. Murat Tuncer
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  7. Gokhan Atis
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  11. Eyup Veli Kucuk
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  14. Kemal Sarica
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Corresponding author

Correspondence to Murat Zor.

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Funding

None to declare. The authors declared that this study has received no financial support.

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors. Due to its retrospective nature, and the survey carried out for the volunteer doctors, ethics committee approval was not required.

Informed consent

Due to its retrospective nature, written informed consent could not obtained from doctors who participated to this study.

Additional information

All authors of the article are the member of the Anatolian Region of Istanbul Stone Research Group [Anadolu Yakası Taş Araştırma Grubu].

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Ates, F., Zor, M., Yılmaz, O. et al. Management behaviors of the urology practitioners to the small lower calyceal stones: the results of a web-based survey. Urolithiasis 44, 277–281 (2016). https://doi.org/10.1007/s00240-015-0825-x

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  • DOI: https://doi.org/10.1007/s00240-015-0825-x

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