Shock Wave Lithotripsy vs Ureteroscopy Variation in Surgical….pdfVIP

Pediatric Urology Shock Wave Lithotripsy vs Ureteroscopy: Variation in Surgical Management of Kidney Stones at Freestanding Children’s Hospitals Hsin-Hsiao Scott Wang, Lin Huang, Jonathan C. Routh and Caleb P. Nelson* From the Department of Urology, Children’s Hospital Boston, Boston, Massachusetts Abbreviations Purpose: Although shock wave lithotripsy has long been considered the gold and Acronyms standard for treatment of kidney stones in children, ureteroscopy has become PHIS Pediatric Health increasingly common. The factors determining procedure choice at individual Information System centers are unclear. We sought to identify patient and hospital factors associated with the choice between shock wave lithotripsy and ureteroscopy. SWL shock wave lithotripsy Materials and Methods: We searched the Pediatric Health Information System URS ureteroscopy hospital database to identify patients with renal calculi who underwent inpatient or outpatient shock wave lithotripsy or ureteroscopy between 2000 and 2008. We Submitted for publication August 29, 2011. used multivariate regression to evaluate whether procedure type was associated * Correspondence: Department of Urology, Children’s Hospital Boston, 300 Longwood Ave., with hospital level factors, including treating hospital, region, size and teaching HU-359, Boston, Massachusetts 02115 (tele- status, or patient level factors, including age, race, gender and insurance type. phone: 617-355-3338; FAX: 617-730-0474; e-mail: Results: We identified 3,377 children with renal stones, of whom 538 (16%) caleb.nelson@). underwent surgery (shock wave lithotripsy in 48%,