Document Detail


Cost-effectiveness and efficiency of shockwave lithotripsy vs flexible ureteroscopic holmium:yttrium-aluminium-garnet laser lithotripsy in the treatment of lower pole renal calculi.
MedLine Citation:
PMID:  21453346     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Study Type - Therapy (cost effectiveness) Level of Evidence 2b What's known on the subject? and What does the study add? Stone management economics is a complex issue. FURS and SWL are recognised treatment option for lower pole kidney stones. There are paucity of data comparing cost implication and effectiveness of both treatment options. Both treatment modalities are equally efficacious. FURS incurred greater cost burden compared to SWL in the UK setting. In the present economic circumstance, clinicians should also consider cost-impact, patient's preference and specific clinical indication when counselling patients for treatment. OBJECTIVE: •  To compare the cost-effectiveness and outcome efficiency of extracorporeal shockwave lithotripsy (SWL) vs intracorporeal flexible ureteroscopic laser lithotripsy (FURS) for lower pole renal calculi ≤20 mm. PATIENTS AND METHODS: •  Patients who had treatment for their radio-opaque lower pole renal calculi were categorized into SWL and FURS group. •  The primary outcomes compared were: clinical success, stone-free, retreatment and additional procedure rate, and perceived and actual costs. •  Clinical success was defined as stone-free status or asymptomatic insignificant residual fragments <3 mm. •  Perceived cost was defined as the cost of procedure alone, and the actual cost included the cost of additional procedures as well as the overhead costs to result in clinical success. RESULTS: •  The FURS (n= 37) and SWL (n= 51) group were comparable with respect to sex, age, stone size and the presence of ureteric stent. •  The final treatment success rate (100% vs 100%), stone-free rate (64.9% vs 58.8%), retreatment rate (16.2% vs 21.6%) and auxillary procedure rate (21.6% vs 7.8%) did not differ significantly. •  The mean perceived cost of each FURS and SWL procedure was similar (£249 vs £292, respectively); however, when all other costs were considered, the FURS group was significantly more costly (£2602 vs £426, P= 0.000; Mann-Whitney U-test). CONCLUSION: •  SWL was efficacious and cost-effective for the treatment of lower pole renal calculi ≤20 mm.
Authors:
Vincent Koo; Michael Young; Trevor Thompson; Brian Duggan
Related Documents :
6210226 - Endoscopic therapy for esophageal carcinoma with nd:yag laser: prospective evaluation o...
11426306 - Carbon dioxide therapy in the treatment of localized adiposities: clinical study and hi...
9142676 - In vivo intravascular laser photodynamic therapy in rabbit atherosclerotic lesions usin...
7962936 - Comparison of the argon tunable dye laser with the flashlamp pulsed dye laser in treatm...
19811956 - Milestones in the management of atrial fibrillation.
17696126 - Health-related quality of life in multiple sclerosis: effects of natalizumab.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-31
Journal Detail:
Title:  BJU international     Volume:  -     ISSN:  1464-410X     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-4-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 THE AUTHORS; BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.
Affiliation:
Stone Treatment Centre, Craigavon Area Hospital, Portadown, and Department of Urology, Belfast City Hospital, Belfast, Northern Ireland, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Transporters in Arabidopsis roots mediating uptake of amino acids at naturally occurring concentrati...
Next Document:  Seasonal variation in prostate-specific antigen levels: a large cross-sectional study of men in the ...