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A cost analysis of stenting in uncomplicated semirigid ureteroscopic stone removal

  • Urology - Original Paper
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Abstract

Objective

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).

Results

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.

Conclusion

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.

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Acknowledgements

The authors thank Mrs. Vögl, Mr. Matula and Mr. Schwartz for their assistance in collecting costing data and Mrs. Wald for proofreading.

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Authors and Affiliations

  1. Department of Urology, Landesklinikum Baden-Mödling, Waltersdorfer Straße 75, 2500, Baden, Austria

    Stephan Seklehner, Paul F. Engelhardt & Claus Riedl

  2. Department of Urology, Paracelsus Medical University Salzburg, Strubergasse 21, 5020, Salzburg, Austria

    Stephan Seklehner, Karl-Dietrich Sievert, Paul F. Engelhardt & Thomas Kunit

  3. Department of Urology, Weill Medical College of Cornell University, New York, NY, USA

    Richard Lee

Authors
  1. Stephan Seklehner
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  2. Karl-Dietrich Sievert
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  3. Richard Lee
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  4. Paul F. Engelhardt
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  5. Claus Riedl
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Correspondence to Stephan Seklehner.

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The authors declares that they have no conflict of interest.

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This article does not contain any studies with human participants performed by any of the authors.

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Seklehner, S., Sievert, KD., Lee, R. et al. A cost analysis of stenting in uncomplicated semirigid ureteroscopic stone removal. Int Urol Nephrol 49, 753–761 (2017). https://doi.org/10.1007/s11255-017-1538-6

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  • DOI: https://doi.org/10.1007/s11255-017-1538-6

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