Current Trends in Urolithiasis Treatment in Various European Health Systems

Objective: In spite of readily available evidence-based guidelines on urolithiasis treatment, practical applications of treatments vary from country to country, or even within countries. The choice of treatment depends not only on the evidence, but often on general non-medical decision factors such as infrastructure, expertise, trends, patient demands, industry drive and reimbursement levels. In turn, many of these factors are interdependent and a result of the individual National Health System. Method: In an attempt to get a crude picture of trends and practices in stone treatment across Europe, a group of well-renowned international experts in the field were asked to reply to a set of standard questions relating to stone treatments, health systems and adherence to guidelines (level of evidence D = expert opinion). Results: The above-mentioned interdependencies showed a varying picture in different countries. Overall, there is a trend away from lithotripsy and toward ureterorenoscopy. However, the choice of treatment is largely dependent on the affordability of infrastructure. Urologists may make choices based on the national reimbursement system, too. Conclusion: Without claiming to represent a scientifiReceived: May 5, 2015 Accepted: September 10, 2015 Published online: November 20, 2015 Dr. Noor Buchholz Sobeh’s Vascular and Medical Center Dubai Health Care City, Building 73, 3rd Floor Dubai (UAE) E-Mail noor.buchholz @ gmail.com © 2015 S. Karger AG, Basel 0042–1138/15/0962–0125$39.50/0 Leopold Durner a Christian Bach c Mohamed El Fatih El Howairis d Oliver W. Hakenberg b Noor Buchholz b, d, e a Harnsteinzetrum, Urologische Klinik Munich-Planegg, Munich , and b Department of Urology, University Hospital Rostock, Rostock , Germany; c Department of Urology, Freeman Hospital, Newcastle upon Tyne , UK; d Department of Urology, Mediclinic City Hospital, and e Department of Urology, Sobeh’s Vascular and Medical Center,