A cost analysis of stenting in uncomplicated semirigid ureteroscopic stone removal
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To evaluate the outcome and the costs of stenting in uncomplicated semirigid ureteroscopic stone removal.
Materials and methods
A decision tree model was created to evaluate the economic impact of routine stenting versus non-stenting strategies in uncomplicated ureteroscopy (URS). Probabilities of complications were extracted from twelve randomized controlled trials. Stone removal costs, costs for complication management, and total costs were calculated using Treeage Pro (TreeAge Pro Healthcare version 2015, Software, Inc, Williamstown Massachusetts, USA).
Stone removal costs were higher in stented URS (€1512.25 vs. €1681.21, respectively). Complication management costs were higher in non-stented procedures. Both for complications treated conservatively (€189.43 vs. €109.67) and surgically (€49.26 vs. €24.83). When stone removal costs, costs for stent removal, and costs for complication management were considered, uncomplicated URS with stent placement yielded an overall cost per patient of €1889.15 compared to €1750.94 without stent placement. The incremental costs of stented URS were €138.25 per procedure.
Semirigid URS with stent placement leads to higher direct procedural costs. Costs for managing URS-related complications are higher in non-stented procedures. Overall, a standard strategy of deferring routine stenting uncomplicated ureteroscopic stone removal is more cost efficient.
KeywordsUreteroscopy Cost–benefit analysis Ureteral calculi Urolithiasis
The authors thank Mrs. Vögl, Mr. Matula and Mr. Schwartz for their assistance in collecting costing data and Mrs. Wald for proofreading.
Compliance with ethical standards
Conflict of interest
The authors declares that they have no conflict of interest.
This article does not contain any studies with human participants performed by any of the authors.
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