Contemporary Trends in Percutaneous Nephrolithotomy in the United States: 1998-2011

Abstract

Objective: To examine trends in percutaneous nephrolithotomy (PCNL) using a serial, cross-sectional study design.

Methods: The Nationwide Inpatient Sample, the largest, publicly available, all-payer, inpatient database, was searched to identify patients of any age who underwent PCNL from 1998 to 2011. Annual procedure incidence rates were estimated using the total US Census Bureau populations.

Results: Data indicated that 105,180 patients underwent PCNL during the study period. The overall annual rate increased from 17 to 31 per million US adults (P < .001), with significant increases among white (P < .001) and Hispanic (P = .03) patients. Both sexes had significant increases in procedure rates: males increased from 17 to 30 per million adults (P < .001), and females increased from 17 to 32 (P < .001). PCNL among patients younger than 18 years was relatively stable (P = .59), whereas among patients aged 18 to 64 years, the procedure rate increased from 39 to 70 per million adults (P < .001), and patients older than 65 years had a larger increase, from 52 to 113 per million (P < .001).

Conclusion: The incidence of PCNL in the United States nearly doubled from 1998 to 2011.