Kidney stone disease

Practice patterns among urologists in Canada

Authors

  • Anis Assad Université de Montreal
  • Mahmoud Moustafa McGill University
  • Brendan L. Raizenne Division of Urology, Centre hospitalier de l’Université de Montréal (CHUM), Université de Montréal, Montreal, QC, Canada
  • Michael Kogon Division of Urology, Mackenzie Health, Vaughan, ON, Canada
  • Jason Y. Lee Division of Urology, University of Toronto, Toronto, Ontario, Canada
  • Michael Ordon Division of Urology, University of Toronto, Toronto, Ontario, Canada
  • Sero Andonian Division of Urology, McGill University, Montreal, Quebec, Canada
  • Andrea Lantz Powers Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada
  • Jennifer Bjazevic Department of Urology, Schulich School of Medicine and Dentistry, London, Ontario, Canada
  • Shubha De Division of Urology, University of Alberta, Edmonton, Alberta, Canada
  • Ben H. Chew Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
  • Naeem Bhojani Division of Urology, Centre hospitalier de l’Université de Montréal (CHUM), Université de Montréal, Montreal, QC, Canada

DOI:

https://doi.org/10.5489/cuaj.8955

Keywords:

kidney stones, medical management, surgical management, practice pattern, metabolic evaluation

Abstract

INTRODUCTION: Despite kidney stone disease (KSD) guidelines, high-quality evidence for KSD management in Canada is lacking. We aimed to assess Canadian urologists’ practice patterns, preferences, and barriers in managing KSD.

METHODS: A cross-sectional survey was distributed to Canadian urologists via the Canadian Urological Association (CUA), Quebec Urological Association (QUA), and Canadian Endourology Group (CEG), as well as directly to urology departments nationwide. Descriptive statistics were used to analyze the results.

RESULTS: Of 93 respondents, 47% were from academic centers, 43% from community hospitals, and 10% from mixed/private settings. Most performed over 75 ureteroscopies and fewer than 25 percutaneous nephrolithotomies (PCNLs) annually (67% and 58%, respectively). Holmium:YAG (Ho:YAG) lasers were available in 85% of hospitals, thulium fiber laser (TFL) in 70%, and Ho:YAG with Moses effect lasers in 28%. Preferred surgical devices included the TFL (74.5%), followed by the Ho:YAG laser (24.2%) and Ho:YAG with Moses effect laser (21.7%). Endourology fellowship-trained urologists (53%) were more likely to perform their own PCNL access (90% vs. 23%, p<0.001), metabolic workup (73% vs. 48%, p=0.02), and felt more comfortable prescribing prophylactic and medical treatment for KSD (86% vs. 50%, p<0.01) compared to non-endourology fellowship-trained colleagues. Metabolic workup was delegated to nephrologists or specialized clinics by 38%, mainly due to lack of time (25%) and expertise (25%). Additionally, 71% lacked access to multidisciplinary KSD clinics, with 76% believing such clinics would be beneficial.

CONCLUSIONS: The study highlights variability in KSD management practices and barriers. Addressing these issues could improve KSD care in Canada and inform future guidelines.

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Published

2025-01-14

How to Cite

Assad, A., Moustafa, M., Raizenne, B. L., Kogon, M. ., Lee, J. Y., Ordon, M. ., … Bhojani, N. . (2025). Kidney stone disease: Practice patterns among urologists in Canada. Canadian Urological Association Journal, 19(5), E153–9. https://doi.org/10.5489/cuaj.8955

Issue

Vol. 19 No. 5 (2025): CUAJ May

Section

Original Research

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