Cost and Effectiveness of Different Treatment Options for Renal Calculi Larger than 2cm.
- Author:
Jin Kyu LIM
1
;
Jae Suk HYUN
;
Ky Hyun CHUNG
Author Information
1. Department of Urology, College of Medicine, Gyeongsang National University, Jinju, Korea. kychung@gshp.gsnu.ac.kr
- Publication Type:Original Article
- Keywords:
Renal calculi;
Extracorporeal shock wave lithotripsy;
Percutaneous nephrolithotomy
- MeSH:
Calculi;
Humans;
Kidney Calculi*;
Lithotripsy;
Nephrostomy, Percutaneous;
Shock
- From:Korean Journal of Urology
2002;43(6):454-458
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The cost and effectiveness of extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PNL), and combined therapy in the treatment of renal calculi larger than 2cm were examined. MATERIALS AND METHODS: A total of 122 patients with renal calculi larger than 2cm, including twenty three cases of staghorn calculi, were divided into two groups, the ESWL group (97 cases) and the PNL group (25 cases), according to the first line of treatment modalities. Each group was divided into two sub-groups according to the need for additional procedures. The stone free rate and duration of treatment of each group were examined. The costs were calculated per patient and based on the cumulative charge of the procedures, which included cost for in-patient care, and treatment of additional procedures and treated complications. RESULTS: In the ESWL group, eighty cases were treated with ESWL only and had a 69% stone free rate. Seventeen cases needed additional procedures including percutaneous nephrostomy, or ureteroscopic procedures, and had a stone free rate of only 41%. In the PNL group, six cases became stone free with PNL only. Nineteen cases required ESWL for residual fragments after PNL, and had a 90% stone free rate. The cumulative average cost per group was as follows: ESWL only, 1,593,260 won; ESWL with additional procedures, 2,130,475 won; PNL only, 1,654,760 won; and PNL with ESWL, 1,973,270 won. The average duration of treatment per group was 47, 112, 5.3 and 8.8 days, respectively. CONCLUSIONS: PNL followed by ESWL, if necessary, is considered the most cost effective method of treating large renal calculi.
