An analysis of stone management over the decade before the COVID-19 pandemic in Germany, France and England.

OBJECTIVES: To understand the implications that the rising upper urinary tract (UUT) stone prevalence in Europe and the increasing burden places on patients and healthcare providers (HCPs), we investigated the evolution of diagnoses and procedures in Germany, France and England over the decade before the coronavirus disease 2019 (COVID-19) pandemic. METHODS: We identified International Classification of Diseases (ICD)-10 codes related to UUT stones diagnosis and extracted procedure volumes for extracorporeal shockwave lithotripsy (ESWL), ureteroscopy (URS), percutaneous nephrolithotomy and open surgery using national procedure codes from the German Institute for the Hospital Remuneration System, the French Technical Agency of Hospitalisation Information and NHS England Hospital Episode Statistics. We analysed procedures vs hospital diagnoses from 2010 to 2019 and reported results per 100 000 inhabitants. RESULTS: Between 2010 and 2019, ICD-10 N20 codes for calculus of kidney and ureter increased by 8%, 26% and 15% in Germany, France, and England respectively; whereas procedures increased by 3%, 38% and 18%. Of the patients diagnosed with stones, the percentage that received treatment (of any type) differed between countries. In 2019, in Germany 83% of patients diagnosed with stones received treatment, in France 88%, and in England 56%. These figures were relatively stable over the 10-year study period. Over the past decade, the dominant procedure shifted from ESWL to URS, and the average length of stay for URS decreased. Day case procedures increased in France and England (by 68% and 23%), no data were available in Germany. CONCLUSION: This analysis highlights an increase in stone diagnoses and procedures, and a shift of surgical management. This development may be due to clinical advantages and advanced technology. The continued stone prevalence rise affects patients, hospitals, and HCPs.

Incidence of neuroendocrine cells in the seminal vesicles and the prostate--an immunohistochemical study.

INTRODUCTION: Prostate and seminal vesicles (sv) are both androgen-dependent male sex accessory glands. The cancer incidence in these two organs is vastly different. Neuroendocrine (NE) cells are involved in the regulation of prostate growth, differentiation and in prostate cancer carcinogenesis. Thus, knowledge of the incidence of NE cells in sv may add to our understanding of prostate cancer etiology. METHODS: Samples of histologically confirmed normal prostate tissue and normal sv tissue from 20 men were immunostained for chromogranin A. The incidence of stained cells was evaluated semiquantitately. RESULTS: Neuroendocrine cells were detected in all prostate specimens, but not a single stained cell was found in any of the sv specimens. CONCLUSIONS: The lack of NE cells and, subsequently, of biogenic amines, peptides and growth factors may be a reason for the low cancer incidence in the seminal vesicles. Alternatively, the absence of NE cells can be seen as a hint that the stem cells of the prostate and sv react differently to endogenous and exogenous stimuli, and thus in the seminal vesicles, stem cells are not transformed into NE cells.