Urology and Andrology

Modern assessment of choosing a treatment for patients with ureteral calculi based on expenditure analysis

The article presents data of world medical literature focussed on the problems of minimally-invasive impact if stones are located in the proximal and distal parts of the ureter, taking into account complications of various approaches and the possible economic burden on the healthcare system. For example, endoscopic surgery demonstrates the greatest effectiveness for removal of stones from the proximal part of the ureteral lumen, which is obtained as soon as after one procedure. The incidence of complications in extracorporeal and endoscopic lithotripsy is comparable, but the costs of treatment can be considerably reduced when the most developed technique of extracorporeal lithotripsy is performed. Factors capable of influencing potential fragmentation of ureteral stones are estimated. When planning this medical procedure, the patient’s metabolic status should be taken into account (weight-to-height ratio), stone density and the distance from the skin to the calculus, which might have a significant effect on the choice of a treatment technique. The issues of the economic expediency of choosing a method of treatment are very important for medical institutions of the Russian Federation but little studied.
Key words: urolithiasis, ureteral stone, endoscopic ureterolithotripsy, extracorporeal lithotripsy, medico-economic costs.
For citation: Dunets K.A., Startsev V.Yu., Lebedev D.G. Modern assessment of choosing a treatment for patients with ureteral calculi based on expenditure analysis. Vopr. urol. androl. (Urology and Andrology). 2019; 7(3): 41–45. (In Russian). DOI: 10.20953/2307-6631-2019-3-41-45