Ethnic and geographic diversity of stone disease.

OBJECTIVES: To ascertain diversity or similarity in stone prevention and problems among different countries around the world. METHODS: Urolithiasis research groups from 10 countries completed a questionnaire. RESULTS: Cost of extracorporeal shock wave lithotripsy (ESWL) was considerably greater than that of drugs in four countries, and equivalent in remaining countries. Stone composition was similar among different countries. Certain urinary risk factors were associated with particular countries, probably from dietary indiscretions. ESWL was used in the majority of patients and open surgery in a minority of patients, except in one country. Medical diagnostic evaluation was used in the majority of patients except in one country. Drug treatment was nonselective, and provided to a minority of recurrent stone-formers. CONCLUSIONS: There is considerable similarity in stone presentations and problems throughout the world. The diversity is likely to be due to nutritional-environmental and socio-political-economic factors.