Sancaktutar AA et al, 2011: Treatment of forgotten ureteral stents: how much does it really cost? A cost-effectiveness study in 27 patients
Sancaktutar AA, Söylemez H, Bozkurt Y, Penbegül N, Atar M
Department of Urology, University of Dicle, Diyarbakır, Turkey
Aim of study was to present costs of forgotten ureteral stents extraction so as to distract attentions of the urologists on this issue. Medical files of 27 accessible patients who referred to our clinics between 2001 and 2010 because of forgotten ureteral stent were retrospectively analyzed. The indwelling time of double-j stents (DJS) was calculated from the time of its insertion. Costs related to radiological investigations, all invasive, and noninvasive interventions, duration of hospital stay, and medical treatments used were calculated. These estimations were based on 2010 prices determined by Turkey Ministry of Health. Mean age of the patients was 31.2 (8-86 years) years. Mean indwelling time of ureteral DJSs was 36.7 months (14-84 months). Seventy-one [extracorporeal shock wave lithotripsy (ESWL), n = 26; invasive/noninvasive interventions, n = 32] procedures were applied for 27 patients. In six patients without incrustation, after a single session of ESWL DJSs could be removed cystoscopically. A various combination of a multimodal therapy was used for other 21 patients. Total financial burden of 27 patients was US $ 34,300. Cost of treatment was estimated to be 6.9-fold (1.8- to 21-fold) higher than an average timely stent extraction. Financial burden of the treatments increased in parallel with the duration of the stent retention (p = 0.001). Management of forgotten DJS is time consuming, difficult, complicated, risky, and costly. Therefore; financial burden, increased labour loss, and impaired quality of life brought by the application of these modalities must not be forgotten.
Urol Res. 2012 Aug;40(4):317-25. doi: 10.1007/s00240-011-0409-3. Epub 2011 Aug 11
PMID: 21833788 [PubMed - as supplied by publisher]
In 27 patients forgotten stents had to be removed. All patients except one pregnant woman were initially treated with one ESWL session. But EWSL alone (7 patients) or in combination with cystoscopic lithotripsy (3 patients) was only successful in 10 altogether. The authors fail to explain why all patients were initially treated with ESWL "DJs could be removed cystoscopically after a single session of ESWL in six patients with no incrustation as detected in KUB." It is also not stated why none of their patients had several ESWL sessions.