Is it Feasible and Cost-Effective to Perform Emergency Ureteroscopic Treatment for Acute Ureteric Colic?

Abstract

Purpose: Ureteroscopy is one of the treatment options for the management of refractory ureteric colic. Emergency Ureteroscopy can provide significant symptomatic relief and may reduce the number of hospital attendances compared to Elective Ureteroscopy. Data regarding cost, however, is scarce. Materials and Methods:In this retrospective review, all patients who underwent ureteroscopic treatment for ureteric colic in the year 2015 were identified. Patients who underwent ureteroscopic during an emergency admission for acute ureteric colic were classified as having had Emergency Ureteroscopy, while those who underwent elective ureteroscopy for ureteric colic were classified as having had Elective Ureteroscopy. Exclusion criteria included urinary tract infection, sepsis, prior ureteroscopic procedures and/or ureteric stenting. The primary outcome evaluated was cost; secondary outcomes included number of preoperative attendances for colic, operative outcomes and complications, as well as hospital re-attendances.Results: A total of 88 patients were identified, with 31 in the Emergency group, and 57 under the Elective group. EM was associated with significantly higher procedural and overall costs (p <0.001), but reduced hospital attendance for colic (p< 0.001). There were no significant differences between both groups in terms of stone clearance rate and postoperative reattendances. Conclusion:Emergency ureteroscopy management of ureteric colic is a reasonable treatment modality that reduces hospital attendance and has similar treatment outcomes as elective ureteroscopic treatment; albeit associated with higher financial costs.