Cost-Effectiveness of Different Treatment Options for Staghorn Calculi

No AccessJournal of UrologyClinical Urology: Original Article1 Nov 1996Cost-Effectiveness of Different Treatment Options for Staghorn Calculi Paramjit S. Chandhoke Paramjit S. ChandhokeParamjit S. Chandhoke More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65448-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The cost-effectiveness of shock wave lithotripsy monotherapy, percutaneous nephrolithotomy and combined sandwich therapy in the treatment of staghorn calculi was examined. Materials and Methods: The cost-effective index, which estimates the average cost of making 1 patient stone-free, was computed for the various treatment options. Data for effectiveness of each therapy were used as available from the literature. Billing charges were used as cost data from University Hospital and the Kidney Stone Center. Results: Average charges for a single percutaneous nephrolithotomy were $26,622, of which 81 percent were facility charges and 7.9 percent urologist fees. Average charges for a single shock wave lithotripsy were $8,213, 60.3 percent of which were facility fees and 33.3 percent of which were urologist charges. Overall, percutaneous nephrolithotomy and combined sandwich therapy were more cost-effective than shock wave lithotripsy monotherapy. When the stone surface area was less than 500 mm.[2] combined sandwich therapy and shock wave lithotripsy monotherapy were equally cost-effective. However, when the stone burden was greater than 500 mm.[2] combined sandwich therapy clearly became more cost-effective than shock wave lithotripsy monotherapy. Conclusions: Percutaneous nephrolithotomy followed by shock wave lithotripsy, if necessary, and second look nephroscopy are the most cost-effective methods of treating staghorn calculi. References 1 : Efficiency quotient as a means of comparing lithotripters. J. Urol., part 21990; 143: 376A. abstract 750. Google Scholar 2 : Nephrolithiasis clinical guidelines panel summary report on the management of staghorn calculi. J. Urol.1994; 151: 1648. Link, Google Scholar 3 : The distinction between cost and charges. Ann. Intern. Med.1982; 96: 102. Google Scholar 4 : Staghorn calculi: analysis of treatment results between initial percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy monotherapy with reference to surface area. J. Urol.1992; 147: 1219. Link, Google Scholar 5 : Differing modes of shock-wave generation. Sem. Urol.1994; 12: 2. Google Scholar 6 : A comparison of anatrophic nephrolithotomy and percutaneous nephrolithotomy with and without extracorporeal shock wave lithotripsy for management of patients with staghorn calculi. J. Urol.1991; 145: 710. Link, Google Scholar 7 : Comparative costs of the various strategies of urinary stone disease management. Urology1995; 46: 15. Google Scholar Department of Surgery (Urology) and Medicine (Renal Diseases), University of Colorado Health Sciences Center, Denver, Colorado.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMOREY A, NITAHARA K and McANINCH J (2018) MODIFIED ANATROPHIC NEPHROLITHOTOMY FOR MANAGEMENT OF STAGHORN CALCULI: IS RENAL FUNCTION PRESERVED?Journal of Urology, VOL. 162, NO. 3 Part 1, (670-673), Online publication date: 1-Sep-1999.May D and Chandhoke P (2018) EFFICACY AND COST-EFFECTIVENESS OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY FOR SOLITARY LOWER POLE RENAL CALCULIJournal of Urology, VOL. 159, NO. 1, (24-27), Online publication date: 1-Jan-1998.Dushinski J and Lingeman J (2018) SIMULTANEOUS BILATERAL PERCUTANEOUS NEPHROLITHOTOMYJournal of Urology, VOL. 158, NO. 6, (2065-2068), Online publication date: 1-Dec-1997.Streem S, Yost A and Dolmatch B (2018) Combination “Sandwich” Therapy for Extensive Renal Calculi in 100 Consecutive Patients: Immediate, Long-Term and Stratified Results from a 10-Year ExperienceJournal of Urology, VOL. 158, NO. 2, (342-345), Online publication date: 1-Aug-1997. Volume 156Issue 5November 1996Page: 1567-1571 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Paramjit S. Chandhoke More articles by this author Expand All Advertisement PDF downloadLoading ...