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- Title
Comparison of success rates and financial cost of extracorporeal shock-wave lithotripsy in situ and after manipulation for proximal ureteral stones.
- Authors
Varkarakis, J.; Protogerou, V.; Albanis, S.; Sofras, F.; Deliveliotis, C.
- Abstract
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. The stone free rate 1 month post treatment was 83% (54/65 patients) for group 1 and 95% (62/65) for group 2. The higher success rate at 1 month for the pushback group was statistically significant (P=0.04) but was correlated with a higher cost (€852 vs €1,008.5). Fifteen additional sessions of SWL and follow up visits were needed in group 1, therefore making the final costs of the two therapeutic pathways almost equal (€1,050.9 vs €1,088.9), with no great difference in the overall fragmentation rates at 3 months between groups (94% and 97%, respectively). Stone manipulation offers higher stone free rates faster than in situ extracorporeal SWL, but is more expensive. This disparity in cost is diminished when costs are corrected for follow-ups and treatment of complications.
- Subjects
LITHOTRIPSY; EXTRACORPOREAL shock wave lithotripsy; EXTRACORPOREAL shock wave therapy; URETER diseases; USER charges; FINANCE charges; SHOCK waves; PATIENTS
- Publication
Urological Research, 2003, Vol 31, Issue 4, p286
- ISSN
0300-5623
- Publication type
Article
- DOI
10.1007/s00240-003-0337-y