Primary SWL Is an Efficient and Cost-Effective Treatment for Lower Pole Renal Stones Between 10 and 20 mm in Size: A Large Single Center Study

Chan, Luke; Good, Daniel W.; Laing, Karina; Phipps, Simon; Thomas, Ben; Keanie, Julian; Tolley, David A.; Cutress, Mark L.

doi:10.1089/end.2016.0825

Cited by 18 publications

(18 citation statements)

References 30 publications

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“…There were 12 studies examining the cost of URS vs. SWL [ 11 – 22 ]. These took place in the USA [ 11 , 12 , 20 , 21 ], China, [ 13 – 15 , 19 ], Egypt [ 16 ], Taiwan [ 17 ] and the UK [ 18 , 22 ].…”

Section: Resultsmentioning

confidence: 99%

“…There were 12 studies examining the cost of URS vs. SWL [ 11 – 22 ]. These took place in the USA [ 11 , 12 , 20 , 21 ], China, [ 13 – 15 , 19 ], Egypt [ 16 ], Taiwan [ 17 ] and the UK [ 18 , 22 ]. Seven of the included studies were retrospective cohort studies [ 12 – 14 , 18 – 21 ] two were prospective cohort studies [ 17 , 22 ] and the remaining three [ 11 , 15 , 16 ].…”

Section: Resultsmentioning

confidence: 99%

“…Stone size was similar between the two groups with a mean size of 10.2 mm (range: 6.2–20 mm) for SWL and 11 mm for URS (range: 6.4–20 mm) (Table 2 ). There were five studies examining stones smaller than 10 mm [ 11 , 12 , 14 , 16 , 20 ], two studies examining stones less than 15 mm [ 20 , 21 ] and five studies examining stones 10 mm and larger [ 12 , 14 , 16 , 17 , 22 ].…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies compared treatment of proximal ureteric stones only [ 12 – 17 , 19 , 21 ]. The others compared distal stones [ 11 ], ureteric stones of all locations [ 18 ] and renal stones [ 20 , 22 ].…”

Section: Resultsmentioning

confidence: 99%

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Ureteroscopy is more cost effective than shock wave lithotripsy for stone treatment: systematic review and meta-analysis

et al. 2018

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IntroductionA rising incidence of kidney stone disease has led to an increase in ureteroscopy (URS) and shock wave lithotripsy (SWL). Our aim was to compare the cost of URS and SWL for treatment of stones.MethodsA systematic review and meta-analysis based on Cochrane and PRISMA standards was conducted for all studies reporting on comparative cost of treatment between URS and SWL. The cost calculation was based on factual data presented in the individual studies as reported by the authors. English language articles from January 2001 to December 2017 using Medline, PubMed, EMBASE, CINAHL, Cochrane library and Google Scholar were selected. Our study was registered with PROSPERO (International prospective register of systematic reviews)—registration number CRD 42017080350.ResultsA total of 12 studies involving 2012 patients (SWL-1243, URS-769) were included after initial identification and screening of 725 studies with further assessment of 27 papers. The mean stone size was 10 and 11 mm for SWL and URS, respectively, with stone location in the proximal ureter (n = 8 studies), distal ureter (n = 1), all locations in the ureter (n = 1) and in the kidney (n = 2). Stone free rates (84 vs. 60%) were favourable for URS compared to SWL (p < 0.001). Complication rates (23 vs. 30%) were non-significantly in favor of SWL (p = 0.11) whereas re-treatment rates (11 vs. 27%) were non-significantly in favor of URS (p = 0.29). Mean overall cost was significantly lower for URS ($2801) compared to SWL ($3627) (p = 0.03). The included studies had high risk of bias overall. On sub-analysis, URS was significantly cost-effective for both stones < 10 and ≥ 10 mm and for proximal ureteric stones.ConclusionThere is limited evidence to suggest that URS is less expensive than SWL. However, due to lack of standardization, studies seem to be contradictory and further randomized studies are needed to address this issue.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Ureteroscopy is more cost effective than shock wave lithotripsy for stone treatment: systematic review and meta-analysis

et al. 2018

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“…1 Chan et al demonstrated that SWL was an excellent choice for rapid and non-invasive treatment of solitary lower pole stones between 10-20 mm. 2 The efficacy and fiscal efficiency for the treatment of smaller (1-10 mm) had previously been demonstrated. 3,4 There remain a number of stones that are not suitable for treatment with SWL.…”

Section: Introductionmentioning

confidence: 99%

Shockwave lithotripsy for urolithiasis: a 12-month analysis of referral data to a metropolitan Australian Hospital

Jaya

Nguyen²,

Tran

et al. 2020

Int Surg J

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Background: Extracorporeal shockwave lithotripsy (SWL) is still an important option in the treatment of renal tract stones. SWL is not without its limitations and alternatives should be considered. This study investigates the referral data to a new SWL planning meeting to identify reasons why SWL was not offered.Methods: A review of 12 months of data prospectively collected at a weekly stone meeting was supplemented with a retrospective chart analysis to identify the source of all referrals for SWL. The principal reason for diverting a patient to other stone management was noted.Results: 142 patients (median age 52 years) were referred for SWL over the 12-month period. SWL was not recommended in 40 (28.2%) patients. SWL was most commonly contraindicated due to excessive stone size±position (32.5%), anatomical complexity (25.0%) and radiolucency on x-ray (10.0%). The majority of patients who were diverted away from SWL were referred from an emergency department (32.5%) and the general urology clinics (20.0%).Conclusions: A significant portion of patients referred for SWL prove unsuitable for this method of stone clearance. This highlights an educational gap amongst clinicians regarding the indications and more importantly contraindications for SWL. Only 6.3% of total referrals originated from general practice suggesting a lack of awareness of the process of direct referral for SWL. Improving this with guidelines will relieve demand in outpatient clinics and help streamline patient care.

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PCNL for Lower Pole Calyceal Stones

Mazzucchi,

Danilovic,

Vicentini

2023

Percutaneous Renal Surgery

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Primary SWL Is an Efficient and Cost-Effective Treatment for Lower Pole Renal Stones Between 10 and 20 mm in Size: A Large Single Center Study

Cited by 18 publications

References 30 publications

Ureteroscopy is more cost effective than shock wave lithotripsy for stone treatment: systematic review and meta-analysis

Ureteroscopy is more cost effective than shock wave lithotripsy for stone treatment: systematic review and meta-analysis

Shockwave lithotripsy for urolithiasis: a 12-month analysis of referral data to a metropolitan Australian Hospital

PCNL for Lower Pole Calyceal Stones

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