The Economic Burden of Cystoscopy-Based Ureteral Stent Removal in the United States: An Analysis of Nearly 30,000 Patients

Ghani, Khurshid R.; Rojanasarot, Sirikan; Cutone, Benjamin; Krambeck, Amy E.

doi:10.1097/upj.0000000000000271

Urology Practice

2022

DOI: 10.1097/upj.0000000000000271

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The Economic Burden of Cystoscopy-Based Ureteral Stent Removal in the United States: An Analysis of Nearly 30,000 Patients

Khurshid R. Ghani

Sirikan Rojanasarot

Benjamin Cutone

et al.

Abstract: and is a paid clinical consultant for Boston Scientific, Coloplast, Lumenis, and Olympus. Amy Krambeck is a Professor of Urology at Northwestern University and is a paid clinical consultant for Ambu, Boston Scientific, Lumenis, and Virtuoso. Drs. Ghani and Krambeck were not compensated for their participation in this study. Sirikan Rojanasarot, Benjamin Cutone, and Samir Bhattacharyya are employees of Boston Scientific.

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“…Benefits of stents with extraction string are lower health care costs in terms of an office visit and procedure, 5 and increased patient convenience. 6-8 While studies have shown extraction strings are associated with adverse events such as dislodgment, 9 very few studies have assessed the relationship between stent dwell time and complications, especially the frequency of postoperative emergency department (ED) visits.…”

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confidence: 99%

What Is the Optimal Stenting Duration After Ureteroscopy and Stone Intervention? Impact of Dwell Time on Postoperative Emergency Department Visits

et al. 2023

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Purpose:AUA stone management guidelines recommend stenting duration following ureteroscopy be minimized to reduce morbidity; stents with extraction strings may be used for this purpose. However, an animal study demonstrated that short dwell time results in suboptimal ureteral dilation, and a pilot clinical study showed this increases postprocedure events. Using real-world practice data we examined stent dwell time after ureteroscopy and its association with postoperative emergency department visits.Materials and Methods:We used the Michigan Urological Surgery Improvement Collaborative registry to identify ureteroscopy and stenting procedures (2016-2019). Pre-stented cases were excluded. Stenting cohorts with and without strings were analyzed. Using multivariable logistic regression we evaluated the risk of an emergency department visit occurring on the day of, or day after, stent removal based on dwell time and string status.Results:We identified 4,437 procedures; 1,690 (38%) had a string. Median dwell time was lower in patients with a string (5 vs 9 days). Ureteroscopy in younger patients, smaller stones, or renal stone location had a higher frequency of string use. The predicted probability of an emergency department visit was significantly greater in procedures with string, compared to without string, when dwell times were less than 5 days (P < .01) but were not statistically significant after.Conclusions:Patients who had ureteroscopy and stenting with a string have short dwell times. Patients are at increased risk of a postoperative emergency department visit around the time of stent removal if dwell time is ≤4 days. We recommended stenting duration of at least 5 days in nonpre-stented patients.

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What Is the Optimal Stenting Duration After Ureteroscopy and Stone Intervention? Impact of Dwell Time on Postoperative Emergency Department Visits

et al. 2023

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Economic burden of complicated ureteral stent removal in patients with kidney stone disease in the USA

et al. 2022

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Aim: To examine the medical costs of simple versus complicated ureteral stent removal. Materials & methods: We included adults with kidney stones undergoing simple or complicated cystoscopy-based stent removal (CBSR) post ureteroscopy from the 2014 to 2018 Merative™ MarketScan® Commercial Database. The medical costs of patients with complicated and simple CBSR were compared. Results: Among 16,682 patients, 2.8% had complicated CBSR. Medical costs for patients with complicated CBSR were higher than for simple CBSR ($2182 [USD] vs $1162; p < 0.0001). Increased stenting time, increased age, southern US geography and encrusted stent diagnoses were significantly associated with complicated CBSR. Conclusion: Complicated ureteral stent removal doubled the medical costs associated with CBSR. Ureteral stents with anti-encrustation qualities may reduce the need for complicated CBSR and associated costs.

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Primary pyeloplasty for uretero-pelvic obstruction in the USA adult population with or without double-J indwelling ureteral stents. Insurance claims data on contemporary time to removal trends, perioperative complications, health care costs, and re-intervention rates

DEL GIUDICE,

HYUN HAN,

TRESH

et al. 2024

Minerva Urol Nephrol

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The Economic Burden of Cystoscopy-Based Ureteral Stent Removal in the United States: An Analysis of Nearly 30,000 Patients

Cited by 3 publications

References 12 publications

What Is the Optimal Stenting Duration After Ureteroscopy and Stone Intervention? Impact of Dwell Time on Postoperative Emergency Department Visits

What Is the Optimal Stenting Duration After Ureteroscopy and Stone Intervention? Impact of Dwell Time on Postoperative Emergency Department Visits

Economic burden of complicated ureteral stent removal in patients with kidney stone disease in the USA

Primary pyeloplasty for uretero-pelvic obstruction in the USA adult population with or without double-J indwelling ureteral stents. Insurance claims data on contemporary time to removal trends, perioperative complications, health care costs, and re-intervention rates

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