Cost-comparison analysis kidney stone

Laser lithotripsy does not play an important role in urinary stone treatment, mostly due to ineffective fragmentation efficiency, and high purchase and maintenance costs. The aim of the following retrospective study was to show the clinical significance and efficiency of an innovative laser lithotripsy system for urinary stone treatment. Between November 1998 and October 1999, 48 patients were treated with the innovative frequency- doubled double-pulse Neodym: YAG laser lithotripter FREDDY. A total of 50 renal units were treated, 43 ureteroscopically, four ureterorenoscopically, three percutaneous-nephroscopically, and one bladder stone cystoscopically...

Our aim was to compare the stone free rate and the financial cost between in situ and after manipulation shock wave lithotripsy (SWL) for proximal ureteral stones. A total of 130 patients with proximal ureteral stones were prospectively randomized into two groups. Sixty-five patients (group 1) underwent SWL in situ and 65 patients (group 2) underwent SWL after an attempt was made to push back the stone into the kidney with the help of a ureteral catheter. The mean per person financial cost of both techniques was estimated after a follow up period of 3 months...

OBJECTIVE: For many years, intravenous urography has been the first-line investigation for renal colic. Since the middle of the 1990s, non-enhanced spiral CT has become a more efficient, less invasive and less expensive alternative to IVU. The aim of this study was to compare non-enhanced spiral CT and IVU in the assessment of renal colic and to evaluate the possibility of exclusive CT assessment in this disease. MATERIAL AND METHODS: Prospective study including 81 patients all undergoing urgent non-enhanced spiral CT, while the first 30 patients were investigated by non-enhanced spiral CT and IVU...

The cost of treating urolithiasis with extracorporeal shockwave lithotripsy and endoscopic surgery continues to be a significant burden on a nation's healthcare economy. Cost-effectiveness evaluations of various medical and surgical treatment options for urolithiasis is a practical method of developing rational allocation strategies for limited economic resources. In this review, the cost-effectiveness of shockwave lithotripsy and that of endoscopic surgery in the management of kidney and ureteral stones are compared...

OBJECTIVES: To report a matched comparison of patients with and without stenting after ureteroscopy for calculi, including middle or proximal ureteral and renal calculi. The elimination of routine stenting after ureteroscopy would prevent stent pain, minimize the need for re-instrumentation, and reduce costs-as long as efficacy and safety are not diminished. METHODS: Of 318 patients who underwent ureteroscopy, 81 (25%) did not have a ureteral stent placed. Of those, 51 were suitable for analysis and included patients with distal ureteral (n = 22), middle or proximal ureteral (n = 11), and renal calculi (n = 18)...

OBJECTIVE: To assess the role of primary open surgery versus the recommended combination approach (percutaneous and lithotripsy) to treat staghorn calculi in a developing country. PATIENTS AND METHODS: Available records (n = 91) of patients with staghorn managed during the last 4 years were retrieved. Patients were placed in two groups, open surgery and combination group, according to the primary procedure chosen by the patient. Demographic data in two groups was comparable in most of the respects except that renal failure patients were more in the combination group...

UNLABELLED: A FREQUENT PROBLEM: Lithiases in the urinary tract form first in the calices, raising complex problems of lithogenesis. As described by Randall, in males caliceal lithiases are often composed of calcium oxalate, generally as a monohydrate. In females, calcium phosphate stones are common, stones related to urease-producing germs are less frequent, and the bi-hydrated form of calcium oxalate predominates. UNPREDICTABLE NATURAL HISTORY: Caliceal lithiases can remain asymptomatic and are often discovered fortuitously...

PURPOSE: We determined the efficacy of extracorporeal shock wave lithotripsy monotherapy and compared its cost-effectiveness with percutaneous nephrolithotomy for the management of lower pole renal calculi. MATERIALS AND METHODS: The efficacy (stone-free rates at 3-months posttreatment) of shock wave lithotripsy with the modified Dornier HM3* machine was determined retrospectively in 114 patients with solitary lower pole renal calculi. Using cost data available from patient billing charges and efficacy data from the literature, the cost-effectiveness for percutaneous nephrolithotomy and shock wave lithotripsy as primary therapy was evaluated...

This study was designed to compare different methods of treating renal calculi in order to establish which was the most cost effective and successful. Of 1052 patients with renal calculi, 350 underwent open surgery, 350 percutaneous nephrolithotomy, 328 extracorporeal shockwave lithotripsy (ESWL), and 24 both percutaneous nephrolithotomy and ESWL. Treatment was defined as successful if stones were eliminated or reduced to less than 2 mm after three months. Success was achieved in 273 (78%) patients after open surgery, 289 (83%) after percutaneous nephrolithotomy, 301 (92%) after ESWL, and 15 (62%) after percutaneous nephrolithotomy and ESWL...

The effectiveness of office ultrasonography of the bladder and kidneys to provide routine urological followup was assessed in the outpatient spinal cord injury clinic. A total of 86 asymptomatic spinal cord injury patients underwent office ultrasonography of the kidneys and bladder as part of the routine urological followup. There were 106 ultrasound scans performed. Of the patients 68 had a blinded excretory urogram for comparison, including 20 who underwent additional studies (computerized tomography scans of the abdomen and pelvis, and/or radiologist-performed ultrasound examinations of the kidneys and bladder)...

This paper presents empirical data from the United Kingdom National Health Service on the comparative mean hospital costs per patient of first generation extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy (PCN) in the treatment of kidney stones. These results were subjected to a sensitivity analysis and related to evidence on the health effects of the two approaches to treatment. The hospital costs of PCN were found to be lower than for ESWL in the empirical comparison and in most but not all the scenarios developed in the sensitivity analysis...