Cost-effectiveness comparison of ureteral calculi treated with ureteroscopic laser lithotripsy versus shockwave lithotripsy

Cone, Eugene B.; Pareek, Gyan; Ursiny, Michal; Eisner, Brian H.

doi:10.1007/s00345-016-1842-2

Cited by 24 publications

(21 citation statements)

References 18 publications

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“…There were 12 studies examining the cost of URS vs. SWL [ 11 – 22 ]. These took place in the USA [ 11 , 12 , 20 , 21 ], China, [ 13 – 15 , 19 ], Egypt [ 16 ], Taiwan [ 17 ] and the UK [ 18 , 22 ]. Seven of the included studies were retrospective cohort studies [ 12 – 14 , 18 – 21 ] two were prospective cohort studies [ 17 , 22 ] and the remaining three [ 11 , 15 , 16 ].…”

Section: Resultsmentioning

confidence: 99%

Ureteroscopy is more cost effective than shock wave lithotripsy for stone treatment: systematic review and meta-analysis

et al. 2018

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IntroductionA rising incidence of kidney stone disease has led to an increase in ureteroscopy (URS) and shock wave lithotripsy (SWL). Our aim was to compare the cost of URS and SWL for treatment of stones.MethodsA systematic review and meta-analysis based on Cochrane and PRISMA standards was conducted for all studies reporting on comparative cost of treatment between URS and SWL. The cost calculation was based on factual data presented in the individual studies as reported by the authors. English language articles from January 2001 to December 2017 using Medline, PubMed, EMBASE, CINAHL, Cochrane library and Google Scholar were selected. Our study was registered with PROSPERO (International prospective register of systematic reviews)—registration number CRD 42017080350.ResultsA total of 12 studies involving 2012 patients (SWL-1243, URS-769) were included after initial identification and screening of 725 studies with further assessment of 27 papers. The mean stone size was 10 and 11 mm for SWL and URS, respectively, with stone location in the proximal ureter (n = 8 studies), distal ureter (n = 1), all locations in the ureter (n = 1) and in the kidney (n = 2). Stone free rates (84 vs. 60%) were favourable for URS compared to SWL (p < 0.001). Complication rates (23 vs. 30%) were non-significantly in favor of SWL (p = 0.11) whereas re-treatment rates (11 vs. 27%) were non-significantly in favor of URS (p = 0.29). Mean overall cost was significantly lower for URS ($2801) compared to SWL ($3627) (p = 0.03). The included studies had high risk of bias overall. On sub-analysis, URS was significantly cost-effective for both stones < 10 and ≥ 10 mm and for proximal ureteric stones.ConclusionThere is limited evidence to suggest that URS is less expensive than SWL. However, due to lack of standardization, studies seem to be contradictory and further randomized studies are needed to address this issue.

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Section: Resultsmentioning

confidence: 99%

Ureteroscopy is more cost effective than shock wave lithotripsy for stone treatment: systematic review and meta-analysis

et al. 2018

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“…Minimally invasive procedures have eased the removal of urinary tract stones [2]. Although ureteral stones were previously managed by open ureter lithotomy, newer techniques, including shock wave lithotripsy (SWL), refinement of semirigid ureter scopes, flexible ureterorenoscopy, and certain laparoscopic procedures have been shown safe and effective in the treatment of ureteral stones, in adults and children [3][4][5].…”

mentioning

confidence: 99%

Comparison of Ureteroscopic Pneumatic Lithotripsy and Extracorporeal Shock Wave Lithotripsy for Proximal Ureteral Calculi

Rehman

Adnan

Hassan

et al. 2020

Cureus

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The goal of this study was to compare the effectiveness and complications of ureteroscopic pneumatic lithotripsy (URS) and extracorporeal shock wave lithotripsy (SWL) in the management of patients with proximal ureteral stones. Methods In this trial, 150 patients presenting with proximal ureteral stones at the Department of Urology of Nishter Hospital Multan from November 2018 to November 2019 were allocated 1:1 to undergo URS or SWL. The presence of stone fragments <4 mm on follow-up was regarded as being stone free. The study outcomes included stone-free rates after first, second, and third treatment sessions and stone retropulsion into the kidneys. Results A total of 75 patients each underwent URS and SWL. The mean procedure times for SWL and URS were 61.61± 3.21 and 85.01±6.75 minutes, respectively (P=0.000), and the mean numbers of procedures were 1.51±0.49 and 1.01±0.42, respectively (P=0.000). Stone-free rates after the first, second, and third sessions of SWL were 64%, 77.3%, and 94.7%, respectively, whereas stone-free rates after the first, second, and third sessions of URS were 86.7%, 92%, and 100%, respectively. Rates of stone retropulsion into the kidneys in the SWL and URS groups were 0% and 6.7%, respectively (P=0.000). Conclusion Compared with SWL, URS had significantly higher stone-free rates in patients with proximal ureteral stones. Treatment costs and hospital stay were lower in the SWL group, whereas complication rates were comparable.

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“…Left flank pain was observed in 51.11% of cases. 24 Stent placement after URS-LL was performed in 66.66% (60/90). In 30 patients, stent placement was not required.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, HU evaluation led us to perform URS-LL in some patients instead of SWL and SWL instead of URS-LL in some patients, which resulted in treatment failure. Also SWL is not a cost-effective treatment option (24). For this reason, a wrong treatment choice leads to a high cost.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hounsfield Unit and İntraoperative “GATA Scale” Score to Determine Requirement of DJ Stent Insertion in Ureteral Stone Treatment

Ediz¹,

Akan²,

Şahin³

et al. 2020

jus

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In this study, we aimed to determine the contribution of hounsfield unit (HU) measurement with non-contrast-enhanced computed tomography to the treatment of a single ureteral stone, and compare the value of HU and intraoperative "GATA scale" score in deciding for DJ stent placement in patients with a single ureteral stone. Materials and Methods: Ninety patients diagnosed with a single ureteral stone in our clinic between January 2018 and September 2018 were evaluated prospectively. We planned a new scale called "GATA scale" with three benchmarks. The validity and reliability of HU were compared with those of GATA scale score. Statistical significance was defined as p<0.05. Results: The mean stone volume at diagnosis was 245.29±23.9 mm 3. The mean HU of ureteral stones was 1065.21±33.5. The mean total score according to GATA scale was 6.44±0.2. To determine the threshold value for factors affecting stent placement after lithotripsy, receiver operating characteristic analysis was performed for stone volume, laser duration, total energy to complete laser lithotripsy and GATA scale score and showed that the optimal thresholds were 164.01 mm 3 , 4.25 mins, 1004 W and 7.5, respectively. Conclusion: In clinical practice, GATA scale can be used in decision making for DJ stents placement. Stent placement following lithotripsy is recommended especially in patients with a stone volume of greater than 160 mm 3 or total energy to complete laser lithotripsy over 1000 W or laser duration longer than 4 minutes or GATA scale score higher than 7.

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Cost-effectiveness comparison of ureteral calculi treated with ureteroscopic laser lithotripsy versus shockwave lithotripsy

Cited by 24 publications

References 18 publications

Ureteroscopy is more cost effective than shock wave lithotripsy for stone treatment: systematic review and meta-analysis

Ureteroscopy is more cost effective than shock wave lithotripsy for stone treatment: systematic review and meta-analysis

Comparison of Ureteroscopic Pneumatic Lithotripsy and Extracorporeal Shock Wave Lithotripsy for Proximal Ureteral Calculi

Comparison of Hounsfield Unit and İntraoperative “GATA Scale” Score to Determine Requirement of DJ Stent Insertion in Ureteral Stone Treatment

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