The introduction of shockwave lithotripsy revolutionized the treatment of patients with renal and ureteral calculi: Instead of subjecting them to morbid surgical procedures, their stones could instead be addressed with a noninvasive, outpatient procedure. The present day now finds us in the early part of an endoscopic epoch in stone management. Although ureteroscopy (URS) was initially concentrated in a limited number of centers, the Clinical Research Office of the Endourological Society (CROES) project very elegantly reports how this technique has diffused on a global scale. URS, as demonstrated by the centers participating in this study, can be performed in a safe and effective manner in a broad range of geographic settings. Although the majority of procedures recorded were semirigid URS, as experience and technology continue to advance, it is likely that flexible URS will become similarly dominant.
With increasing emphasis being placed on healthcare resource utilization, studies such as the present one will become extremely valuable in the coming years—such robust sources of data, as CROES provides, will allow powerful comparative effectiveness analyses to be performed, particularly with the competitive modalities that exist for stone management.
