[Current aspects of stone therapy].
More than 30 % of all admissions to an urologic clinic are for the treatment of urinary stones. In almost all cases, the treatment is minimally invasive employing extracorporeal shock wave lithotripsy (ESWL), ureterorenoscopy (URS) or percutaneous nephrolithotomy (PCNL). Technical advances in endourology and a growing expertise in ESWL led to a decline in ESWL and an increase in endoscopic techniques. In comparison with ESWL, the endoscopic techniques are more invasive but in most cases achieve a stone free state faster. With the introduction of diagnosis related groups (DRG), the economic aspect of stone therapy is gaining in importance. Stone prevention leads to a cost reduction in the health care system, justifying the use of an appropriate stone metaphylaxis. This review article presents the current recommendations for interventional urinary stone therapy and lists the options of conducting both medical and economically rational therapy.
Knoll
T
T
Urologische Klinik, Universitätsklinikum Mannheim. t.knoll@uro.ma.uni-heidelberg.de
Wendt-Nordahl
G
G
Trojan
L
L
Wenke
A
A
Roeder
N
N
Alken
P
P
D003363:Cost Control; D003362:Cost-Benefit Analysis; D003953:Diagnosis-Related Groups / Q000191:economics; D005858:Germany; D006801:Humans; D007669:Kidney Calculi / Q000191:economics / Q000628:therapy*; D008096:Lithotripsy / Q000191:economics; D009313:National Health Programs / Q000191:economics; D009403:Nephrostomy, Percutaneous / Q000191:economics; D010043:Outcome and Process Assessment, Health Care; D014514:Ureteral Calculi / Q000191:economics / Q000628:therapy*; D018666:Ureteroscopy / Q000191:economics