Ultra-mini PCNL versus flexible ureteroscopy: a matched analysis of treatment costs (endoscopes and disposables) in patients with renal stones 10-20 mm.

Abstract

PURPOSE:

Latest publications state equal efficacy of a recently introduced new percutaneous technique ("ultra-mini PCNL", UMP) and flexible ureteroscopy (fURS) in the treatment of medium-size urinary stones. Today we face challenges concerning cost-effectiveness and reduction of in-hospital length of stay. In this retrospective study, we compare clinical outcome parameters and costs of treatment (endoscopes and disposables) of both techniques.

METHODS:

Thirty patients treated by UMP at two tertiary university centres were matched to 30 fURS patients from previously recorded databases. Data analysis included operating time, length of stay, stone-free rates (SFR), complications (>Clavien II), ancillary procedures (presurgical ureteral stenting, secondary ureteral stenting or placement of a nephrostomy tube, secondary procedures) and costs for disposable materials and instruments (endoscopes, as calculated per procedure).

RESULTS:

We found no significant differences in operating times (UMP vs. fURS: 121/102 min), hospital length of stay (2.3/2.0 days), SFR (84/87 %) and complications (7/7 %). Costs for disposable materials and endoscopes were 656 euro (UMP) and 1,160 euro (fURS) per procedure.

CONCLUSIONS:

UMP and fURS are both safe and effective in the treatment of medium-size urinary stones. Costs for endoscopes and disposable materials are significantly lower in UMP.

• Authors: Martin Schoenthaler, Konrad Wilhelm, Simon Hein, Fabian Adams, Daniel Schlager, Ulrich Wetterauer, Azad Hawizy, Andreas Bourdoumis, Janak Desai, Arkadiusz Miernik
• Journal: World journal of urology (World J Urol) Vol. 33 Issue 10 Pg. 1601-5 (Oct 2015) ISSN: 1433-8726 [Electronic] Germany
• PMID: 25614255 (Publication Type: Journal Article, Multicenter Study)

Topics

• Adolescent
• Adult
• Aged
• Equipment Design
• Female
• Health Care Costs
• Humans
• Kidney Calculi (surgery)
• Male
• Middle Aged
• Nephrostomy, Percutaneous (instrumentation)
• Operative Time
• Retrospective Studies
• Ureteroscopes
• Ureteroscopy (instrumentation)
• Young Adult