結石の外科的治療(医療経済の観点から)

Abstract

Surgical treatment for upper urinary stones has dramatically changed since extracorporeal shock wave lithotripsy (ESWL) was introduced in 1985 in Japan. Since then, the number of ESWL apparatus is increasing year by year, and there were about 800 ESWL apparatus available in Japan in 2001. On the other hand, the number of patients with upper urinary stones are also increasing in Japan, and the age-adjusted annual incidence of first-episode upper urinary tract stones in 1995 was estimated at 68.9 per 100, 000 (100.1 in men and 55.4 in women), a steady increase from 54.2 in 1965. Under these circumstances, it would be very important to treat stone patients surgically even from an economical point of view, because the cost of ESWL is very expensive and more than 90% of the patients with urolithiasis are now treated by ESWL. In this paper, the medical economics of urolithiasis in Japan is discussed especially in the surgical treatment.