Elsevier

European Urology

Volume 44, Issue 6, December 2003, Pages 709-713
European Urology

Study on the Prevalence and Incidence of Urolithiasis in Germany Comparing the Years 1979 vs. 2000

https://doi.org/10.1016/S0302-2838(03)00415-9Get rights and content

Abstract

Objectives: In 1979, we conducted a representative study to determine the prevalence and incidence of urolithiasis in Germany. Significant progress in stone therapy and changes in nutritional and environmental factors since then consequently led to a second study in 2001 under the same conditions as in 1979.

Methods: A representative sample of 7500 persons from all over Germany was questioned on the occurrence of urinary stones during their lifetimes (prevalence) and on acute urolithiasis in 2000 (incidence). Additionally, data were collected on urinary stone therapy and metaphylaxis. The current data were then compared with those from 1979.

Results: Prevalence has risen from 4% to 4.7% from 1979 to 2001. 9.7% of the 50–64 year old males in 2000 had already had urinary stones (females: 5.9%). The current recurrence rate of urinary stones was estimated to be 42%.

In the year 2000, the incidence of urolithiasis in Germany was found to be 1.47% (1979: 0.54%). Over 40% of the stones were passed spontaneously.

Conclusion: There has been a marked increase in the prevalence and incidence of urolithiasis in Germany within the last 22 years. This probably results from improvements in clinical-diagnostic procedures, changes in nutritional and environmental factors and a general apathy towards metabolic clarification and metaphylaxis.

Introduction

Epidemiological data on the occurrence of urolithiasis ranges between 2 and 20% [1], [2], [3]. Precise data on the epidemiology of a disease or disorder can only be determined if geographical position, race, age and sex, climate, nutrition and other environmental factors are also taken in consideration. The parameter “occurrence” is determined by two factors: (1) the incidence, i.e. the number of new disease cases per population measured over a given time interval and (2) the prevalence, i.e. the portion of people in a population who found to be with disease at a certain point in time. A representative survey of the incidence and prevalence of a disease is only possible using randomly selected samples of the general population questioned in face-to-face interviews or by telephone. Comparisons between different regions or countries are only permissible when the survey criteria are comparable. One explanation for the large fluctuations in the urolithiasis data gathered from different countries is that these were based only on selected groups, such as males over the age of 40, urban or rural populations.

Only few reports on the epidemiology of urolithiasis are available based on nation-wide surveys [4], [5], [6], [7]. The overall structure of the population has not always been taken into account in these studies [4], [8]. These studies produced prevalence data ranging from 4% [6] to 14.8% [7].

Chronological studies have shown that urolithiasis is on the increase. Within 10 years (1975–1985) the prevalence rose from 4 to 5.4% in Japan [5]. In 1979, we conducted a representative study for the Federal Republic of Germany, which showed the prevalence of urolithiasis to be 4.0% and the incidence 0.54% [6]. Using the same survey structure, this survey was repeated in 2001, so that reliable data on the development of urolithiasis would be obtained over the 22-year period.

Section snippets

Materials and methods

In co-operation with INFAS (Institute for Applied Social Science) two representative, epidemiological surveys on urolithiasis were conducted (1979 and 2001).

In each case the questions relating to urolithiasis were posed within the framework of a multi-topic survey. In 1979, the survey was conducted face-to-face on a representative sample of 10,130 people. In 2001, 7500 people were included in the survey and were asked by telephone interviews. They were selected by following different criteria

Prevalence

The prevalence of urolithiasis has increased from 4.0 to 4.7% within 22 years (Table 1).

In the year 2001, 5.5% of males and 4.0% of females stated that they had already suffered from urinary stones once or more. The mean ratio between male and female was 1.4:1.

For patients over the age of 50 the prevalence was 9.7% for males and 5.9% for females (Fig. 1).

Analysis of the age when urolithiasis occurred for the first time amongst all stone patients interviewed in 2001 revealed a marked increase in

Discussion

In former times, most epidemiological studies of urolithiasis were based on hospital statistics, general practice surveys or selected group surveys [9], [10]. These produced many interesting details regarding this multifactorial disease, but, for a number of different epidemiological reasons, they are inadequate for determining the true prevalence and incidence in a population. Furthermore, a comparison between different countries, and a chronological assessment is not possible using data from

Acknowledgements

This study was supported by grants of the German Society of Shock Wave Lithotripsy, Dornier Medizintechnik (Wessling/Germany), Philips Medizin Systeme (Hamburg/Germany) and STORZ Medical (Kreuzlingen/Germany).

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