Korean J Urol.  2005 Nov;46(11):1141-1146.

Comparison of Cost and Clinical Outcome for Ureteral Stones Larger than 1cm; Extracorporeal Shock Wave Lithotripsy versus Ureteroscopic Lithotripsy

• Kim HH
• Noh JH

Abstract

PURPOSE: To compare extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic removal of stone (URS) on the basis of success rate, cost effectiveness, safeness, cause of failure, complication, and auxiliary procedures in treating ureteral stones larger than 1cm.
MATERIALS AND METHODS
From January 2001 to April 2005, 72 cases were treated with URS using 7.5Fr or 9.5Fr rigid ureteroscopy and 110 cases with in situ Direx Compact ESWL. The mean stone sizes of URS and ESWL were 12.8mm and 13.1mm, respectively, and all were larger than 10.0 mm.
RESULTS
In the URS, the overall success rate and the mean operative time were 88.9% (64/72 cases) and 68 minutes, respectively. According to stone site, the success rates of upper, mid and lower ureteral stones were 83.3% (15/18 cases), 84.6% (11/13 cases) and 92.6% (38/41 cases), respectively. The first session and total treatment, stone-free rates for ESWL were 34.5% (38/110 cases) and 79.0% (87/110 cases), respectively. The complication rates associated with URS and ESWL were 13.8% (10/72 cases) and 11.8% (13/110 cases), respectively. All complications were managed successfully with conservative treatment. Overall costs were similar for both modalities, but detailed cost analysis (e.g. follow-up loss patient) was not performed.
CONCLUSIONS
Both URS and ESWL are effective treatments for stones larger than 1cm, but ureteroscopy with intracorporeal lithotripsy is the more efficient and cost effective method.

Keyword

Ureteroscopy; Ureteral calculi

MeSH Terms

Cost-Benefit Analysis
Costs and Cost Analysis
Lithotripsy*
Operative Time
Shock*
Ureter*
Ureteral Calculi
Ureteroscopy