Renal Calculi Clinical Trial
Official title:
Cost-Effectiveness of Different Treatment Options for Lower Calyceal Stones of 1 to 2 Centimeters: A Prospective, Randomized Study
The aim of the present study to perform a full cost analysis for the complete clearance of calyceal stones by retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PNL) for the treatment of lower calyceal stones between 1 and 2 centimeters (cm) in size.
The lifelong prevalence of urinary system stone disease is approximately 15%. The lower calyx
is the most common location where renal calculi occur. Because anatomical factors preclude
spontaneous passage in this area, the need for treatment is more likely in lower calyceal
stones. The European Association of Urology (EAU) suggests percutaneous nephrolithotomy (PNL)
for stones larger than 2 centimeters (cm) and shock wave lithotripsy (SWL) or retrograde
intrarenal surgery (RIRS) for stones smaller than 1cm as a first option, but controversy
continues regarding the best treatment option for medium-sized lower calyceal stones of
between 1cm and 2cm.
Medical costs are divided into two components: direct and indirect. Direct costs encompass
all medical expenditures (e.g., drugs, hospital bed, all consumable and non-consumable
materials used during the operation), while indirect costs include loss of working days for
the patient. The stone-free rates (SFR) are reported as approximately 60% and 90% for one
session of RIRS and PNL, respectively; however, no physician can guarantee a 100% SFR for one
session. For this reason, a full cost analysis must include the direct and indirect costs of
both the first and all auxiliary procedures.
The aim of this study was to perform a full cost analysis for the complete clearance of
calyceal stones by RIRS and all PNL types for the treatment of lower calyceal stones between
1cm and 2cm in size.
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