1530 ureteroscopic lithotripsy under local anesthesia in treating distal ureteral stone; a comparison of morbidity, effectiveness, patient satisfaction and costs with other treatment methods

You have accessJournal of UrologyStone Disease: SWL, Ureteroscopy or Percutaneous Stone Removal (I)1 Apr 20131530 URETEROSCOPIC LITHOTRIPSY UNDER LOCAL ANESTHESIA IN TREATING DISTAL URETERAL STONE; A COMPARISON OF MORBIDITY, EFFECTIVENESS, PATIENT SATISFACTION AND COSTS WITH OTHER TREATMENT METHODS Sangrak Bae, Youngik Lee, Hyoungkeun Park, Hyeonggon Kim, Wonhee Park, Yongsoo Lho, and Sunghyun Paick Sangrak BaeSangrak Bae Seoul, Korea, Republic of More articles by this author , Youngik LeeYoungik Lee Seoul, Korea, Republic of More articles by this author , Hyoungkeun ParkHyoungkeun Park Seoul, Korea, Republic of More articles by this author , Hyeonggon KimHyeonggon Kim Seoul, Korea, Republic of More articles by this author , Wonhee ParkWonhee Park Incheon, Korea, Republic of More articles by this author , Yongsoo LhoYongsoo Lho Seoul, Korea, Republic of More articles by this author , and Sunghyun PaickSunghyun Paick Seoul, Korea, Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In this study we investigated that safety, effectiveness, patient satisfaction and cost of ureteroscopy under local anesthesia (URS-LA)comparing with ureteroscopy under spinal anesthesia (URS-SA) and shockwave lithotripsy (SWL). METHODS Between January 2010 and January 2011, patients with 5mm sized or distal ureteral stone that were eligible to undergo both SWL and URS were enrolled. All patients were counseled on the particularities of each treatment, and they actively participated in the decision process. Patients were followed-up for the stone free rates, complications, and total treatment duration. To evaluate the subjective pain and satisfaction, 10-point visual pain scale (during URS-LA and SWL), and 5 point-satisfactory questionnaire were asked to patients after procedures. We also asked whether to get the same treatment when recur. Total cost was calculated based on the cumulative fees for the preoperative examinations, operation, perioperative monitoring, postoperative care, office visits, and any ancillary procedures and retreatment procedures. RESULTS A total of 105 patients were studied, and divided to 3 groups; URS-LA (n=36), URS-SA (n=47), and SWL groups (n=22). All URS were performed successfully, and stone free rate was 100%. In SWL group, mean number of SWL sessions was 1.6 (range 1-4), and stone free rate was 100%. The average pain scale was significantly lower in URS-LA group (4.4¡¾2.3) compare with SWL group (5.9¡¾1.2). The average hospital stay was 1.1¡¾0.4 days in URS-LA group, and 2.5¡¾1.3 days in URS-SA group. All SWL was performed on an outpatient basis and total treatment duration was 18.0 days. The incidence rate of complications was13.9% in URS-LA group, 12.8% in URS-SA, and 13.6% in SWL group (p=0.988). All complications have been mitigated by conservative treatment. The satisfactory point was 4.2 in URS-LA, 4.3 in URS-SA, and 4.0 in SWL group (p=0.530). In addition, patients answered to get the same treatment when the urinary stone occurs again 89% in URS-LA,77% in URS-SA, and 77% in SWL(p=0.411). The mean cumulative cost was US $758.8 in URS-LA group $1365.3 in URS-SA, and $1145.0 in SWL group. CONCLUSIONS The results of this study suggest that the URS-LA is safe, effective, and satisfactory treatment method compare with URS-SA and SWL in distal ureteral stone. The pain during URS-LA is lower than SWL. And URS-LA is the most cost-effective and rapid method in treating distal ureter stone. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e627 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sangrak Bae Seoul, Korea, Republic of More articles by this author Youngik Lee Seoul, Korea, Republic of More articles by this author Hyoungkeun Park Seoul, Korea, Republic of More articles by this author Hyeonggon Kim Seoul, Korea, Republic of More articles by this author Wonhee Park Incheon, Korea, Republic of More articles by this author Yongsoo Lho Seoul, Korea, Republic of More articles by this author Sunghyun Paick Seoul, Korea, Republic of More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...