title: Ultra-mini PCNL versus flexible ureteroscopy: a matched analysis of treatment costs (endoscopes and disposables) in patients with renal stones 10-20 mm.
abstract: OBJECTIVE
  Latest publications state equal efficacy of a recently introduced new percutaneous technique ("ultra-mini PCNL", UMP) and flexible ureteroscopy (fURS) in the treatment of medium-size urinary stones. Today we face challenges concerning cost-effectiveness and reduction of in-hospital length of stay. In this retrospective study, we compare clinical outcome parameters and costs of treatment (endoscopes and disposables) of both techniques.
  
  
  METHODS
  Thirty patients treated by UMP at two tertiary university centres were matched to 30 fURS patients from previously recorded databases. Data analysis included operating time, length of stay, stone-free rates (SFR), complications (>Clavien II), ancillary procedures (presurgical ureteral stenting, secondary ureteral stenting or placement of a nephrostomy tube, secondary procedures) and costs for disposable materials and instruments (endoscopes, as calculated per procedure).
  
  
  RESULTS
  We found no significant differences in operating times (UMP vs. fURS: 121/102 min), hospital length of stay (2.3/2.0 days), SFR (84/87 %) and complications (7/7 %). Costs for disposable materials and endoscopes were 656 euro (UMP) and 1,160 euro (fURS) per procedure.
  
  
  CONCLUSIONS
  UMP and fURS are both safe and effective in the treatment of medium-size urinary stones. Costs for endoscopes and disposable materials are significantly lower in UMP.
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Schoenthaler
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Konrad
authors.initials: K
authors.lastname: Wilhelm
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Hein
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Adams
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Schlager
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wetterauer
authors.affiliation: Department of Urology, Endourology and Stone Services, Royal London Hospital, Bartshealth NHS Trust, London, E1 1BB, UK.
authors.forename: Azad
authors.initials: A
authors.lastname: Hawizy
authors.affiliation: Department of Urology, Endourology and Stone Services, Royal London Hospital, Bartshealth NHS Trust, London, E1 1BB, UK.
authors.forename: Andreas
authors.initials: A
authors.lastname: Bourdoumis
authors.affiliation: Department of Urology, Samved Hospital, Nr. Stadium Circle, Navrangpura, Ahmedabad, 380 009, Gujarat, India.
authors.forename: Janak
authors.initials: J
authors.lastname: Desai
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany. arkadiusz.miernik@uniklinik-freiburg.de.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Miernik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation*; D061646:Operative Time; D012189:Retrospective Studies; D020709:Ureteroscopes; D018666:Ureteroscopy / Q000295:instrumentation*; D055815:Young Adult
keywords: Costs of treatment; Flexible ureteroscopy; Nephrolithiasis; Ultra-mini percutaneous nephrolithotomy