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• W2141383286 abstract "INTRODUCTION AND OBJECTIVES: Medium-sized renal stones are primarily treated with one of three methods: ureteroscopy (URS), shockwave lithotripsy (SWL), or percutaneous nephrolithotomy (PCNL). Many studies have addressed the efficacy of these procedures, but evaluating the relative costs is rarely done because actual cost data (not charge data) is not readily available. In this study, we used an innovative tool to evaluate the efficacy and cost of treating medium-sized renal stones. METHODS: We retrospectively identified all adult patients treated from January 2012 to December 2013 for unilateral, 10-20 mm renal stones with URS, SWL, or PCNL by a single surgeon. Patient demographics, stone characteristics, procedural data, and complications were obtained from electronic medical records. Efficacy was measured by the stone free rate (SFR). Complications were defined as seeking medical attention for urinary symptoms/complaints within 30 days of treatment, e.g. UTI, hematuria, flank pain. Costs were calculated using a proprietary cost-allocation tool developed at the University of Utah (Value Driven Outcomes, VDO). We used VDO to itemize and assign all costs associated with each patient episode including all postoperative visits, both routine and unexpected. Importantly, the allocated costs are independent of hospital charges. RESULTS: Forty-two patients met inclusion criteria. Demographics and stone characteristics are similar between all three groups. The cost of SWL was set at 1.0; other costs are relative to SWL. PCNL is the most expensive, and PCNL and SWL have similar retreatment and complication rates. URS is more expensive than SWL but has the lowest retreatment and complication rates, as well as the highest SFR (see table). CONCLUSIONS: For medium-sized renal stones, SWL is the least expensive for a single episode of care, but URS offers the best balance between efficacy and cost when compared to SWL and PCNL. In an era of healthcare cost concerns, this study supports VDO as being a valuable tool in evaluating the relative costs of different treatment modalities for the same disease." @default.
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• W2141383286 date "2014-11-01" @default.
• W2141383286 modified "2023-10-18" @default.
• W2141383286 title "S051: Comparison of flexible ureterorenoscopy and mini percutaneous nephrolithotomy in treatment of lower calyceal stones smaller than 2 cm" @default.
• W2141383286 doi "https://doi.org/10.1016/s1569-9056(14)61646-8" @default.
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