Epidemiology of Large Renal Stones and Utilization Patterns of Percutaneous Nephrolithotom

Patients with large renal calculi comprise a unique subpopulation of patients with urolithiasis. As percutaneous nephrolithotomy is generally the first-line treatment for large and complex stones, review of series of patients undergoing percutaneous nephrolithotomy and examination of utilization patterns can offer insight into the epidemiology of these stones where data are otherwise lacking. Large population-based studies suggest that percutaneous nephrolithotomy utilization rates have remained steady over the last two decades. However, there are a number of socioeconomic factors, independent of medical and surgical indications, that may influence the utilization of this treatment modality, including physician training and experience, patient demographics and cost considerations, that may confound the use of percutaneous nephrolithotomy treatment as a surrogate for large stones.