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Ultra-mini PCNL versus flexible ureteroscopy: a matched analysis of treatment costs (endoscopes and disposables) in patients with renal stones 10–20 mm

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Abstract

Purpose

Latest publications state equal efficacy of a recently introduced new percutaneous technique (“ultra-mini PCNL”, UMP) and flexible ureteroscopy (fURS) in the treatment of medium-size urinary stones. Today we face challenges concerning cost-effectiveness and reduction of in-hospital length of stay. In this retrospective study, we compare clinical outcome parameters and costs of treatment (endoscopes and disposables) of both techniques.

Methods

Thirty patients treated by UMP at two tertiary university centres were matched to 30 fURS patients from previously recorded databases. Data analysis included operating time, length of stay, stone-free rates (SFR), complications (>Clavien II), ancillary procedures (presurgical ureteral stenting, secondary ureteral stenting or placement of a nephrostomy tube, secondary procedures) and costs for disposable materials and instruments (endoscopes, as calculated per procedure).

Results

We found no significant differences in operating times (UMP vs. fURS: 121/102 min), hospital length of stay (2.3/2.0 days), SFR (84/87 %) and complications (7/7 %). Costs for disposable materials and endoscopes were 656 euro (UMP) and 1,160 euro (fURS) per procedure.

Conclusions

UMP and fURS are both safe and effective in the treatment of medium-size urinary stones. Costs for endoscopes and disposable materials are significantly lower in UMP.

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Abbreviations

fURS:

Flexible ureteroscopy

PCNL:

Percutaneous nephrolithotomy

SFR:

Stone-free rate(s)

SWL:

Shock wave lithotripsy

UMP:

Ultra-mini PCNL

URS:

Ureteroscopy

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Conflict of interest

Martin Schoenthaler Consultant contract with Schoelly GmbH, Denzlingen, Germany and NeoTract Inc., Pleasanton, USA; Ulrich Wetterauer Advisory board, DR. KADE Pharmazeutische Fabrik GmbH, Berlin; Janak Desai Royalty payments form LUT GmbH, Dezlingen, Germany and Arkadiusz Miernik Consultant contract with Schoelly GmbH, Denzlingen, Germany. The study received no external funding.

Ethical standard

The study has been approved by the local ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.

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Correspondence to Arkadiusz Miernik.

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German Clinical Trial Register ID DRKS00006957.

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Schoenthaler, M., Wilhelm, K., Hein, S. et al. Ultra-mini PCNL versus flexible ureteroscopy: a matched analysis of treatment costs (endoscopes and disposables) in patients with renal stones 10–20 mm. World J Urol 33, 1601–1605 (2015). https://doi.org/10.1007/s00345-015-1489-4

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  • DOI: https://doi.org/10.1007/s00345-015-1489-4

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