Article ; Online: Comparing extracorporeal shock wave lithotripsy and ureteroscopy laser lithotripsy for treatment of urinary stones smaller than 2 cm: a cost-utility analysis in the Spanish clinical setting.
2021 Volume 39, Issue 9, Page(s) 3593–3598
Abstract: Purpose: To analyze the efficiency and cost-utility profile of ureteroscopy versus shock wave lithotripsy for treatment of reno-ureteral stones smaller than 2 cm.: Methods: Patients treated for urinary stones smaller than 2 cm were included in this ... ...
| Abstract | Purpose: To analyze the efficiency and cost-utility profile of ureteroscopy versus shock wave lithotripsy for treatment of reno-ureteral stones smaller than 2 cm. Methods: Patients treated for urinary stones smaller than 2 cm were included in this study (n = 750) and divided into two groups based on technique of treatment. To assess the cost-utility profile a sample of 48 patients (50% of each group) was evaluated. Quality of life survey (Euroqol 5QD-3L) before-after treatment was applied, Markov model was designed to calculate quality of life in each status of the patients (stone or stone-free with and without double-J stent) and to estimate the incremental cost-utility. Monte carlo simulation was conducted for a probabilistic sensitivity analysis. Chi-square was used for comparing qualitative variables and T student's for continuous variables. Results: Shock wave lithotripsy group had 408 (54.4%) and ureteroscopy group had 342 (45.6%) patients. Of them, 56.3% were treated for renal stones and 43.7% for ureteral stones. Ureteroscopy produced slightly higher overall quality of patients' life, but produced a significant higher overall cost per quality-adjusted life year (QALY) than shock wave lithotripsy, exceeding the cost-utility threshold (20,000€/QALY). Sensitivity analysis confirmed results in 93.65% of cases. Difference was maintained in subgroup analysis (ureteral vs renal stones). Conclusions: Results suggest that in our clinical setting shock wave lithotripsy has better cost-utility profile than ureteroscopy for treatment of reno-ureteral stones less than 2 cm, but excluding waiting times, in ideal clinical setting, ureteroscopy would have better cost-utility profile than shock wave lithotripsy. |
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| MeSH term(s) | Adult ; Aged ; Cost-Benefit Analysis ; Female ; Humans ; Kidney Calculi/economics ; Kidney Calculi/pathology ; Kidney Calculi/therapy ; Lithotripsy ; Lithotripsy, Laser ; Male ; Middle Aged ; Spain ; Treatment Outcome ; Ureteral Calculi/economics ; Ureteral Calculi/pathology ; Ureteral Calculi/therapy ; Ureteroscopy |
| Language | English |
| Publishing date | 2021-02-22 |
| Publishing country | Germany |
| Document type | Comparative Study ; Journal Article |
| ZDB-ID | 380333-8 |
| ISSN | 1433-8726 ; 0724-4983 |
| ISSN (online) | 1433-8726 |
| ISSN | 0724-4983 |
| DOI | 10.1007/s00345-021-03620-w |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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