Cost-effective analysis of pneumatic and laser lithotripsy techniques in ureteral stones
Journal Title: Dicle Tıp Dergisi - Year 2013, Vol 40, Issue 1
Abstract
Objective: Ureteroscopic lithotripsy (URSL) is a common treatment alternative in ureteral stones. We aimed to evaluate pneumatic and laser lithotripsy techniques, which are used for fragmentation of stones. Materials and methods: The data of 100 patients who underwent URSL by using pneumatic and laser lithotriptors were analyzed. The sample divided in 2 groups, each including 50 patients. URSL was performed in lithotomy position under general anesthesia. The absence of residual stone at second week urinary system graphy was accepted as the criteria of success. We evaluated the presence of differences in terms of efficiency and costeffectivity of pneumatic and laser lithotripsy techniques. Results: The mean ages were 42 and 45 years, respectively. The mean operation time was 43.1 min in pneumatic group and 40 min in laser group. Stone-free rates were found 93.9% and 78%, respectively. The stone migration rate was determined 16% in pneumatic group and 4.1% in laser group. Complication rates were 4.1% in pneumatic group and 8% in laser group. The cost analysis showed that pneumatic lithotriptor device cost 10000 TL and laser lithotriptor system cost 76000 TL. Nevertheless, the Social Security Administration paid the same cost for both lithotripsy techniques. Conclusion: Higher stone-free and lower stone migration rates were determined in laser lithotripsy application. Therefore, low incidence of the requirement of subsequent secondary treatments for residual stones in laser treatment decreased the treatment costs. Nevertheless, the cost is significantly higher in laser technique. It requires more detailed studies. Key words: Ureteral stone, ureteroscopy, lithotripsy, efficiency, cost
Authors and Affiliations
Mehmet Yüksel, İlker Çelen, Erdem Özbek, Bilali Gümüş
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