1553 PREOPERATIVE STENTING DECREASES COST OF URETEROSCOPY

Abstract

You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal1 Apr 20111553 PREOPERATIVE STENTING DECREASES COST OF URETEROSCOPY Lei Chu, Coreen Farris, Anthony Corcoran, and Timothy Averch Lei ChuLei Chu Pittsburgh, PA More articles by this author , Coreen FarrisCoreen Farris Pittsburgh, PA More articles by this author , Anthony CorcoranAnthony Corcoran Pittsburgh, PA More articles by this author , and Timothy AverchTimothy Averch Pittsburgh, PA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1561AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ureteral stent placement prior to ureteroscopic stone intervention may facilitate both access and stone removal by passively dilating the ureter. This study examines the impact of preoperative stent placement on total health care cost of ureteroscopic stone intervention. METHODS We retrospectively reviewed the records of patients who underwent ureteroscopic stone intervention by one surgeon at our institution from 2002 to 2009. A cost model was used to compare total health care costs for prestented and matched non-stented patients with large (>1cm) and small (<1cm) stone burden using actual cost accrued for each individual patient. One-way, two-way and ratio sensitivity analysis examined the robustness of the cost model. RESULTS There were 104 patients included in the study (45 prestented, 59 non-prestented). Median stone size was 1cm (range 0.3–4cm). Overall stone clearance was 95.8%. Prestenting decreased cost in patients with stones >1cm: median cost were $16,190 and $27,445 in prestented and non-prestented cohorts, respectively (p=0.01). However, prestenting increased cost for stones <1cm: median cost were $13,815 and $10,127 in prestented and non-prestented cohorts, respectively (p=0.01). One-way sensitivity analysis showed that despite varying each of 15 cost parameters, prestenting remains cost saving for >1cm stones. In two-way sensitivity analysis, surgery time and number of surgeries were varied simultaneously, prestenting remains cost saving provided total operative time does not rise above 1.6 times the current estimate. Ratio cost analysis showed cost of prestenting would need to rise 12 times before it ceases to be cost saving. CONCLUSIONS Preoperative stent placement is cost effective for successful ureteroscopic intervention in patients with larger stone burden >1cm. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e623-e624 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lei Chu Pittsburgh, PA More articles by this author Coreen Farris Pittsburgh, PA More articles by this author Anthony Corcoran Pittsburgh, PA More articles by this author Timothy Averch Pittsburgh, PA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...