Cost-comparison analysis kidney stone

Ultrasound (US) imaging is a widely used medical imaging modality for the diagnosis, monitoring, and surgical planning for kidney conditions. Thus, accurate segmentation of the kidney and internal structures in US images is essential for the assessment of kidney function and the detection of pathological conditions, such as cysts, tumors, and kidney stones. Therefore, there is a need for automated methods that can accurately segment the kidney and internal structures in US images. Over the years, automatic strategies were proposed for such purpose, with deep learning methods achieving the current state-of-the-art results...

CONTEXT: The incidence of urolithiasis is increasing year by year. Ureteral stents are a popular treatment option for this condition. Efforts to improve the material and structure of stents to increase comfort and reduce complications have led to the introduction of magnetic stents. OBJECTIVE: To evaluate differences in removal efficiency and safety for magnetic and conventional stents. EVIDENCE ACQUISITION: This study was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...

INTRODUCTION: The use of modern information technologies allows to increase confidence in the choice of a surgical treatment method of kidney stones, as well as to improve the quality of treatment due to an adequate combination of therapeutic techniques. MATERIALS AND METHODS: In our study we analyzed the treatment results of 625 patients with kidney stones. We created a register with the information on more than 50 parameters for each patient. Each example had an output parameter representing a predefined treatment strategy (extracorporeal shock-wave lithotripsy [ESWL]-1, percutaneous nephrolithotomy [PCNL]-2, pyelolithotomy or nephrolithotomy-3)...

Both shock wave lithotripsy (SWL) and flexible ureterorenoscopy (F-URS) are recommended as the first choice for non-lower pole kidney stones. Therefore, we conducted a prospective study to evaluate the efficacy, safety, and cost of SWL versus F-URS in patients with solitary non-lower pole kidney stones ≤ 20 mm under the COVID-19 pandemic. This prospective study was conducted in a tertiary hospital from June 2020 to April 2022. Patients who underwent lithotripsy (SWL or F-URS) for non-lower pole kidney stones were enrolled in this study...

Background and Objectives : Disposable flexible ureteroscopes have been widely used because of their cost-effectiveness and higher sterility potential compared with reusable flexible ureteroscopes. This study aimed to compare the surgical outcomes and complication rates in patients who undergo reusable or disposable flexible ureteroscopic stone surgeries (fURS) for urinary stone disease. Materials and Methods : A systematic review and meta-analysis were conducted under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline...

Our objective was to identify the rate of revisit to either emergency department (ED) or inpatient (IP) following surgical stone removal in the ambulatory setting, and to identify factors predictive of such revisits. To this end, the AHRQ HCUP ambulatory, IP, and ED databases for NY and FL from 2010 to 2014 were linked. Cases were selected by primary CPT for shock-wave lithotripsy (SWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PNL) with accompanying ICD-9 for nephrolithiasis. Cystoscopy (CYS) was selected as a comparison group...

Introduction: Infectious complications after ureteroscopy (URS) for stone disease lead to emergency department visits, hospitalizations, and other costly health care utilization. The objective of our study was to identify risk factors for postoperative fever (POF) and systemic inflammatory response syndrome (SIRS) after URS for stone disease. Materials and Methods: We performed a retrospective cohort study on 2746 patients who underwent 3298 URS for stone disease at Geisinger from 2008 to 2016. A univariate analysis tested the associations between candidate demographic, preoperative, and intraoperative predictors and the primary outcome of POF (temperature >100...

PURPOSE: To describe and validate a novel CT approach using volumetric analysis for renal stone surveillance. MATERIALS AND METHODS: This prospective trial consisted of a standard low-dose non-contrast CT (SLD) of the abdomen and pelvis, immediately followed by an ultra-low-dose non-contrast CT (ULD) with reconstruction limited to the kidneys. A novel dedicated software tool was applied that automates stone volume, density, and maximum linear size. Manual linear stone size was measured by a radiology fellow and urology resident for comparison...

PURPOSE: Nowadays, there are many physical and chemical methods available for urinary stone analysis. According to the latest guidelines, infrared spectroscopy (IR) or x-ray diffraction (XRD) are the two preferred methods in this issue. Therefore, we decided to do a practical comparison between the two above-mentioned techniques with a reference method in order to set up a proper analysis method in our clinical laboratories. MATERIALS AND METHODS: A total of 60 kidney stones were obtained at Labbafinejad hospital through open surgery or percutaneous nephrolithotomy...

OBJECTIVE: To evaluate and compare the effectiveness of ureteroscopic (URS) pneumatic lithotripsy versus extracorporeal shock wave lithotripsy (ESWL) in the management of the proximal ureteral stones in terms of stone- free rates, complications and costs involved. MATERIAL AND METHODS: We included 200 patients in Group 1 who underwent ESWL and 200 patients in Group 2 who underwent URS intervention. We used Modulith SL X lithotripter 3rd generation Storz medical for ESWL group while Swiss pneumatic lithoclast was used to break the stone in the URS group...

OBJECTIVE: The increasing number of flexible ureterorenoscopy (fURS) procedures, the fragility of devices, and their growing maintenance and repair costs represent a substantial burden for urologic departments. Disposable single-use fURS devices offer many advantages over reusable fURS. Among them, the LithoVue™ model shows the best clinical utility. In our study, we assessed the economic aspects of reusable fURS application compared with the potential costs and benefits of single-use fURS (LithoVue™)...

BACKGROUND: Ureteric colic, the term used to describe the pain felt when a stone passes down the ureter from the kidney to the bladder, is a frequent reason for people to seek emergency health care. Treatment with the muscle-relaxant drugs tamsulosin hydrochloride (Petyme, TEVA UK Ltd) and nifedipine (Coracten(®), UCB Pharma Ltd) as medical expulsive therapy (MET) is increasingly being used to improve the likelihood of spontaneous stone passage and lessen the need for interventional procedures...

BACKGROUND: Urolithiasis (kidney stones) is a common reason for Emergency Department (ED) visits, accounting for nearly 1% of all visits in the United States. Computed tomography (CT) has become the most common imaging test for these patients but there are few comparative effectiveness data to support its use in comparison to ultrasound. This paper describes the rationale and methods of STONE (Study of Tomography Of Nephrolithiasis Evaluation), a pragmatic randomized comparative effectiveness trial comparing different imaging strategies for patients with suspected urolithiasis...

PURPOSE: To evaluate the cost-effectiveness of shockwave lithotripsy (SWL) vs ureteroscopic lithotripsy (URS) for patients with renal stones <1.5 cm in diameter. METHODS: Patient age, stone diameter, stone location, and stone-free status were recorded for patients treated with SWL or URS for renal stones <1.5 cm in maximal diameter over a 1-year period. Institutional charges were obtained from in-house billing. A decision analysis model was constructed to compare the cost-effectiveness of SWL and URS and using our results and success rates for modeling...

OBJECTIVES: To examine the effect of preoperative stent placement on total cost of ureteroscopic stone intervention. Passive ureteral dilation with a preoperative ureteral stent has been proposed as a method to facilitate both upper tract access and stone removal. METHODS: We retrospectively reviewed the records of patients who underwent ureteroscopic stone intervention at our institution from 2005 to 2009. A sample of patients who had undergone stenting before ureteroscopy was selected and nonstented matched controls were used as a comparison group...

BACKGROUND AND PURPOSE: Three small diameter (<1.5F) stone baskets have recently been introduced. Our objective was to evaluate the stone capture rate of these baskets in an in vitro ureteral model and an in vitro caliceal model using novice, resident, and expert operators. MATERIALS AND METHODS: Sacred Heart Medical Halo™ (1.5F), Cook N-Circle(®) Nitinol Tipless Stone Extractor (1.5F), and Boston Scientific OptiFlex(®) (1.3F) stone baskets were tested in an in vitro ureteral and a caliceal model by three novices, three residents, and three experts...

PURPOSE: We performed a cost comparison of immediate second look flexible nephroscopy vs expectant management for post-percutaneous nephrostolithotomy residual fragments. MATERIALS AND METHODS: We used a decision analysis model to compare the cost of managing residual fragments by second look flexible nephroscopy vs observation. Outcomes of residual fragments after percutaneous nephrostolithotomy were determined from institutional experience and published shock wave lithotripsy series...

(1) The first-line treatment for patients with partial epilepsy is carbamazepine monotherapy. Second-line options include monotherapy with valproic acid, gabapentin, lamotrigine or oxcarbazepine. Other antiepileptics are also available for combination therapy of refractory partial epilepsy. (2) Zonisamide is a sulphonamide derivative that inhibits carbonic anhydrase; it resembles topiramate, a drug already approved for use for this indication in the European Union. (3) The main clinical trial, a double-blind study lasting 36 weeks, compared the addition of zonisamide or placebo to ongoing treatment in 351 patients with refractory partial epilepsy...

Although medical therapy is known to reduce the risk of kidney stone recurrence, the cost effectiveness of medical prophylaxis is controversial. We evaluated medical treatment strategies including dietary measures (conservative), empiric medical therapy (empiric) or directed medical therapy (directed) based on comprehensive metabolic evaluation (CME) for patients with recurrent kidney stones, and compared the costs of these strategies using cost data from ten different countries. We previously established rates of stone formation in recurrent stone-formers, risk reduction of medical therapy, sensitivity of CME and rates of spontaneous stone passage from a comprehensive literature search (Lotan et al...

More than 30 % of all admissions to an urologic clinic are for the treatment of urinary stones. In almost all cases, the treatment is minimally invasive employing extracorporeal shock wave lithotripsy (ESWL), ureterorenoscopy (URS) or percutaneous nephrolithotomy (PCNL). Technical advances in endourology and a growing expertise in ESWL led to a decline in ESWL and an increase in endoscopic techniques. In comparison with ESWL, the endoscopic techniques are more invasive but in most cases achieve a stone free state faster...