Economics of stone management.
Cost, in addition to efficacy and morbidity, has become an important factor in determining the best therapeutic modality for a variety of disease states. A comprehensive literature search finds that, in general, for staghorn calculi, percutaneous nephrostolithotomy is more cost-effective than shock wave lithotripsy (SWL) for stones greater than 2 cm in any dimension, while SWL may be cost-effective for smaller stones. For ureteral stones, observation is the least costly treatment strategy. Among surgical options, ureteroscopy is less costly than SWL. For single and recurrent stone formers, medical prophylactic strategies involving drug therapy are more costly than conservative therapy involving dietary measures alone. However, drug strategies yield fewer stone recurrences.
Department of Urology, The University of Texas Southwestern Medical Center, J8.112, 5323 Harry Hines Blvd., Dallas, TX 75390, USA. yair.lotan@utsouthwestern.edu
Yair
Y
Lotan
Margaret S
MS
Pearle
D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006801:Humans; D008096:Lithotripsy / Q000191:economics; D009403:Nephrostomy, Percutaneous / Q000191:economics; D018666:Ureteroscopy / Q000191:economics; D052878:Urolithiasis / Q000191:economics* / Q000628:therapy*