Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan;12(1):59-65.
doi: 10.1016/j.ajur.2024.04.001. Epub 2024 Apr 23.

The impact of urolithiasis on urology services in a high-prevalence region: A multicenter study

Wissam Khalid Kamal  1 , Musab M Alghamdi  1 , Raed A Azhar  2 , Ahmad Bugis  2 , Mohammed Abuzenada  1 , Majed Alharthi  1 , Saeed Bin Hamri  3 , Yahya Ghazwani  4   5   6 , Yasser A Noureldin  7   8 , Hassan Aljifri  9 , Abdulaziz Alamri  10 , Hatem Hamed Althubiany  11 , Mansour Alnazari  12 , Badr Alharbi  13 , Abdulrahman Al Own  14 , Mohanad Jebril Bosily  14 , Mohammed Almansour  15 , Abdullah Alfakhri  16 , Ibrahim Alowidah  17 , Ali Abdel Raheem  17   18
Affiliations

The impact of urolithiasis on urology services in a high-prevalence region: A multicenter study

Wissam Khalid Kamal et al. Asian J Urol. 2025 Jan.

Abstract

Objective: To assess the effect of upper urinary tract (UUT) urolithiasis on urology services in a region with a high prevalence of the condition, and analyze the trends in endourological procedures for treating UUT urolithiasis and the cost of treatments in 11 hospitals over the last 6 years.

Methods: Using the hospital surgery statistics database, data were gathered from the urology departments of 11 hospitals in Saudi Arabia. The analysis focused on the trends, distribution, and annual cost of endourological procedures for UUT urolithiasis from January 2017 to December 2022.

Results: Out of the total surgery performed (54 711), over half (31 039, 57%) were related to UUT urolithiasis. Extracorporeal shock wave lithotripsy (ESWL) was the most performed procedure among stone-related procedures, accounting for 38% of all procedures. Double-J stent insertion, flexible ureteroscopy (URS), semi-rigid URS, percutaneous nephrolithotomy, and pyelo- and uretero-lithotomy accounted for 25%, 19%, 14%, 3.8%, and 0.35%, respectively. Notably, the number of stone-related UUT procedures in 2022 increased by 35% (from 4671 to 6283) compared to 2017. In the year 2022 compared to 2017, there was a statistically significant increase in the rate of all stone-related UUT procedures (p<0.001), except for ESWL and pyelo- and uretero-lithotomy. The rates of ESWL procedures reduced from 21% in 2017 to 13% in 2022 (p<0.001). Overall, the total cost of treatments has been estimated to be about 192.1 million SAR from 2017 to 2022 with an increase by 107% (47.7 million SAR in 2022 vs. 23.0 million SAR in 2017).

Conclusion: Our research findings suggest that urolithiasis poses a significant burden, accounting for over half of all urological surgery performed at the participating centers. Furthermore, there has been a 35% rise in stone-related UUT procedures over the past 6 years. Percutaneous nephrolithotomy, flexible URS, and semi-rigid URS have experienced significant increase in usage. Furthermore, in 2022 the cost of urolithiasis treatments has been more than doubled compared to 2017.

Keywords: Extracorporeal shock wave lithotripsy; Percutaneous nephrolithotomy; Saudi Arabia; Ureteroscopy; Urinary stone.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The number and distribution of stone and non-stone-related surgical procedures from 2017 to 2022 in all hospitals.
Figure 2
Figure 2
The number and distribution of different endourology surgical procedures for the treatment of upper urinary tract urolithiasis from 2017 to 2022 in all hospitals. URS, ureteroscopy; fURS, flexible URS; PCNL, percutaneous nephroscopy; ESWL, extracorporeal shock wave lithotripsy; DJ, double-J.
Figure 3
Figure 3
The stone-related procedure change of semi-rigid URS, fURS, PCNL, and ESWL. (A) The yearly absolute number change; (B) The yearly absolute percentage change. URS, ureteroscopy; fURS, flexible URS; PCNL, percutaneous nephroscopy; ESWL, extracorporeal shock wave lithotripsy.
Figure 4
Figure 4
The annual urolithiasis procedures' cost from the year 2017 to 2022 in all hospitals.
See this image and copyright information in PMC

References

    1. Raheem O.A., Khandwala Y.S., Sur R.L., Ghani K.R., Denstedt J.D. Burden of urolithiasis: trends in prevalence, treatments, and costs. Eur Urol Focus. 2017;3:18–26. - PubMed
    1. Zhang L., Zhang X., Pu Y., Zhang Y., Fan J. Global, regional, and national burden of urolithiasis from 1990 to 2019: a systematic analysis for the global burden of disease study 2019. Clin Epidemiol. 2022;15:971–983. - PMC - PubMed
    1. Lang J., Narendrula A., El-Zawahry A., Sindhwani P., Ekwenna O. Global trends in incidence and burden of urolithiasis from 1990 to 2019: an analysis of global burden of disease study data. Eur Urol Open Sci. 2022;35:37–46. - PMC - PubMed
    1. Roberson D., Sperling C., Shah A., Ziemba J. Economic considerations in the management of nephrolithiasis. Curr Urol Rep. 2020;21:18. doi: 10.1007/s11934-020-00971-6. - DOI - PubMed
    1. New F., Somani B.K. A complete world literature review of quality of life (QOL) in patients with kidney stone disease (KSD) Curr Urol Rep. 2016;17:88. doi: 10.1007/s11934-016-0647-6. - DOI - PMC - PubMed

LinkOut - more resources