Contemporary practice patterns associated with percutaneous nephrolithotomy among certifying urologists.

Area of Science:

• Urology
• Surgical Procedures
• Health Services Research

Background:

• Percutaneous nephrolithotomy (PCNL) is a key treatment for complex kidney stones.
• Understanding factors influencing PCNL adoption is crucial for optimizing care.

Purpose of the Study:

• To evaluate how urologist-specific factors impact PCNL use.
• To analyze trends in PCNL utilization over time.

Main Methods:

• Analysis of self-reported case logs from The American Board of Urology (2004-2013).
• Stratification of urologists by fellowship training, practice type, and population.
• Examination of procedural trends over the study period.

Main Results:

• Newly certified urologists (53%) and fellowship-trained urologists (66%) were more likely to perform PCNL.
• Urologists with fellowship training had higher rates of high-volume PCNL (>10 procedures).
• PCNL procedures increased by 117% from 2004 to 2012.

Conclusions:

• Younger and fellowship-trained urologists are the main adopters of PCNL.
• The majority of senior urologists do not perform PCNL.
• PCNL use and surgeon-controlled access have risen significantly in the last decade.