Changes in Gender Distribution of Urinary Stone Disease

doi:10.1016/j.urology.2009.08.007

Urology

Volume 75, Issue 3, March 2010, Pages 543-546.e1

https://doi.org/10.1016/j.urology.2009.08.007 Get rights and content

Objectives

To explore using population-based data the extent to which gender-specific rates of stone disease are changing. Historically, stone disease has been more common among men than women. However, differential changes in dietary intake patterns, fluid intake, and obesity in men and women may cause shifts in stone disease incidence and prevalence.

Methods

The State Ambulatory Surgical Database and the State Inpatient Databases were queried for procedures related to renal colic or urolithiasis. Population-based rates of utilization were calculated for the years 1998-2004 by gender. Poisson regression models were fit to measure changes in utilization rates over time.

Results

Of the 107 411 discharges for stone disease, 41 272 (38%) occurred in women. Service utilization increased in both men and women (86.6-105.5 and 42.5-64.4 per 100 000; P <.01 in both). However, the growth rate in women outpaced men (P <.01). Rates of outpatient (57.2-65.8 and 27.0-38.9 per 100 000; P <.01) and ambulatory surgery center utilization (6.4-17.7 and 2.9-9.3 per 100 000 men and women; P <.01) increased significantly in men and women, but inpatient utilization only increased in women (12.5-16.3 per 100 000; P <.01).

Conclusions

Resource utilization for stone disease continues to increase. Most of this increase appears to be due to an increase in disease among women. Increasing obesity, dietary changes, or decreased fluid intake may be contributing to the rapid increase in stone disease treatments in women.

Section snippets

Study Cohort

We identified subjects from the Florida State Ambulatory Surgery Database (SASD) and State inpatient database (SID) who underwent surgery for stone disease in 1998, 2000, 2002, and 2004. The SASD and SID are compendiums of datasets from 24 state data organizations administered by the Federal Agency for Healthcare Research and Quality as part of the Healthcare Cost and Utilization Project, and they provide patient-level discharge data for 100% of patients from facilities in the participating

Results

Overall procedures for urolithiasis increased significantly between 1998 and 2004. Total discharges related to urinary stone disease increased from 129.1 to 169.9 per 100 000 (P <.01). Utilization among men increased from 86.6 to 105.5 per 100 000 (Fig. 1; 22% increase), while utilization by women increased from 42.5 to 64.4 per 100 000 (Fig. 1; 52% increase). Although procedure use in both genders increased (P <.01 for both groups), the rate of growth in women was significantly greater than in

Comment

Resource utilization increased for stone disease in both men and women. However, growth was significantly faster in women than in men. Utilization of outpatient surgical settings grew for both men and women, but only women showed an increase in inpatient hospitalizations. These results suggest that treatment of stone disease is increasing in both genders and that nephrolithiasis is becoming more common in women.

This study supports recent findings of changing gender distributions of upper

Conclusions

Resource utilization for urinary stone disease increased by 22% for men and 52% for women, reflecting an increasing resource use in women compared with men. These findings support the contention that the prevalence of stone disease is increasing in women. Importantly, inpatient admissions did not increase in men, but grew by 23% in women, resulting in an 8% increase in overall utilization. This increased use of inpatient resources in women suggests that the incidence of stone disease among

References (13)

C.M. Johnson et al.
Renal stone epidemiology: a 25-year study in Rochester, Minnesota
Kidney Int
(1979)
J.C. Lieske et al.
Renal stone epidemiology in Rochester, Minnesota: an update
Kidney Int
(2006)
C.D. Scales et al.
Changing gender prevalence of stone disease
J Urol
(2007)
M.S. Pearle et al.
Urologic diseases in America project: urolithiasis
J Urol
(2005)
K.K. Stamatelou et al.
Time trends in reported prevalence of kidney stones in the United States: 1976-94
Kidney Int
(2003)
B. West et al.
Metabolic syndrome and self-reported history of kidney stones: the national health and nutrition examination survey (NHANES III) 1988-94
Am J Kidney Dis
(2008)

There are more references available in the full text version of this article.

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Endourology and StonesChanges in Gender Distribution of Urinary Stone Disease

Objectives

Methods

Results

Conclusions

Section snippets

Study Cohort

Results

Comment

Conclusions

Kidney Int

Kidney Int

J Urol

J Urol

Kidney Int

Am J Kidney Dis

Endourology and Stones
Changes in Gender Distribution of Urinary Stone Disease