Impacting Kidney Stone Care is Urgent Business

Many people are surprised to learn that one in every 10 Americans will experience kidney stones in their lifetime. While most kidney stones are the size of a chickpea, they can reach the size of a golf ball and cause severe pain and other serious complications, sending more than half a million people each year to the emergency room. 

Studies have shown that the incidence of kidney stones is on the rise in the United States and this patient demand is quickly outpacing the number of available urologists. For every new urologist entering the field, 10 practitioners are ready to retire.^,

One of the most rewarding aspects of my role as president of Urology for Boston Scientific is taking complex challenges like these head on. By collaborating across our teams and listening to our customers, we create and iterate on technologies that can bring relief for patients experiencing these conditions, while providing urologists with more options to address growing needs.  

Supporting an Overburdened Urology Workforce

Practicing urologists today face extraordinary pressures on their time and are limited in the number of patients they can reasonably treat. The incidence of burnout has been shown to be highest in surgical specialties, with U.S. urologists reporting burnout rates of up to 68%. 

Urologists experiencing burnout are more likely to reduce their hours, resign their positions and retire early, all of which contribute to a shortage in the workforce. The need for more effective technology to positively impact and streamline the treatment of kidney stones has never been more urgent.

Persistent clinical inefficiencies have presented limitations and opportunities to raise the bar. For instance, reusable ureteroscopes, which are used to view and remove kidney stones, require a lengthy sanitation process that may be costly to maintain and often takes scopes out of commission for extended periods of time.^, This may force urologists to space patient procedures further apart or delay scheduled stone removals because clean devices aren’t readily available. Beyond this, for many years, urologists relied on another person during kidney stone retrieval to operate a wire basket to collect kidney stones. 

Recognizing these operational frustrations, we introduced the first single-use ureteroscope in 2016, and have since developed a compatible stone retrieval accessory device to turn the historically two-person task of ureteroscope operation and stone basketing into a single-person procedure, providing greater procedural control for the surgeon. Over the years, we’ve seen surgery centers continue to embrace single-use ureteroscopes because the efficiency benefit outweighs the reprocessing burden of reusable scopes.

Innovating to Alleviate Burdens and Impact Patient Care

As the prevalence of kidney stones increases and demands faced by urologists evolve, medical device companies must continue to innovate to support urologists in the limited time they have available, with the shared goal of improving outcomes for patients receiving treatment. 

For example, another clinical challenge involves the connection between increased pressure in the kidneys during stone procedures and the potential for resulting complications. Elevated intrarenal pressure can occur during ureteroscopies because of fluid irrigation, which is used to maintain a clear visual field throughout the procedure. High intrarenal pressure may contribute to a range of post-operative complications, including sepsis and renal damage.^,

To help urologists monitor intrarenal pressure in real time during procedures, we created a next-generation version of our single-use flexible ureteroscope, which includes a built-in pressure sensor. The device was developed with urologist feedback and is designed to offer functionality and a new level of in-procedure information that urologists have never had before. 

We’re not alone in this commitment, and I truly believe that through a collaborative approach, across providers, payers and the medical device industry, we can leverage our shared expertise to take on even the most challenging stone procedures – remaining focused on our collective goal of maintaining quality of life for patients. 

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