Cost-effectiveness analysis of different methods of endoscopic treatment for patients with unextended ureteral strictures

Popov S.V., Skryabin O.N., Orlov I.N., Chernysheva D.Yu.

Introduction: There is a lack of understanding the costeffectiveness of endoscopic management of non-extended ureteral strictures nowadays. The aim of this paper is to work up the algorithm of reducing the expenses for endoscopic management of non-extended ureteral strictures and to choose the optimal endoscopic for that purpose. 

Material and methods: From 2007 to 2014 in Center of endourology and new technologies, Saint-Petersburg, Russia, were performed 117 endoureterotomies – 38 were done by laser energy, 37 – by electro-cautery energy and 42 by cold-knife. The age of patients were from 21 to 56 years old. All patients received the standard diagnostic procedures (blood tests, ultrasound of kidneys, computed tomography of retroperitoneal space with contrast media). Average follow-up was 20.6 months. Cost-effectiveness was calculated using Cost-effectiveness ratio formula. 

Results: The frequency of ureteral stricture relapses was 31.6% in case of laser endoureterotomy, in 32.4% case of cold-knife endoureterotomy and 35.7%for electric endoureterotomy. The efficacy of laser and cold-knife endoureterotomy were showed to be equal (р< 0,05). The expenses for laser endoureterotomy is 13614.6 Rub, cold-knife endoureterotomy – 19914.6 Rub. Cost-effectiveness ration is 199.0 for laser endoureterotomy and 309.7 for cold-knife endoureterotomy. 

Conclusion: the use of laser energy for endoureterotomy can minimize the expenses of hospital for endoscopic management of non-extended ureteral strictures. 

Authors declare lack of the possible conflicts of interests. 

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ureteral stricture, endoureterotomy, cost effectiveness