Article ID: 2026.05.005
Background The surgical management of benign prostatic hyperplasia (BPH) and upper urinary tract stones has remarkably evolved with technological advances. In this study, the trends in surgical techniques for these conditions in the San-in region of Japan were analyzed over a 10-year period.
Methods A retrospective survey was conducted across 17 urological facilities in the San-in region (Tottori and Shimane prefectures) from 2014 to 2023. Data on the surgical procedures for BPH and upper urinary tract stones were collected, including the facility adoption rates and annual case volumes.
Results For BPH treatment, HoLEP and bipolar TUR-P were the commonly performed procedures, with HoLEP accounting for approximately 50% of all cases. Minimally invasive surgical treatments, including water vapor energy (WAVE) and prostatic urethral lift (PUL), were introduced in 2022. For upper urinary tract stones, the utilization of TUL/URS equipped with holmium laser dramatically increased from 33.9% to 64.9% of all cases, whereas that of extracorporeal shock wave lithotripsy (ESWL) decreased from 59.9% to 32.1%.
Conclusion This study shows the successful adoption of advanced urological techniques in rural Japan, with clear trends toward laser-based procedures for BPH and stone treatment. The observed decline in ESWL utilization is consistent with national and international trends, reflecting a global paradigm shift toward the endoscopic management of upper urinary tract stones.
