The relative cost-effectiveness of PCNL and ESWL for medium sized (2 cms) renal calculi in a tertiary care urological referral centre

• Main Authors: Pradeep P Rao, Rasesh M Desai, Ravindra B Sabnis, Snehal H Patel, Mahesh R Desai
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2001-01-01
• Series: Indian Journal of Urology
• Subjects: Kidney Stones; SWL; PCNL; Cost-effectiveness; Medium Sized; Indian
• Online Access: http://www.indianjurol.com/article.asp?issn=0970-1591;year=2001;volume=17;issue=2;spage=121;epage=123;aulast=Rao
• ISSN: 0970-1591; 1998-3824

There is a paucity of cost-effectiveness studies in India comparing PCNL and ESWL in the treatment of renal cal-culi. We are dependent on costing studies from western literature, although the nature of expenses in developed countries is quite different from those in India. This study compares the two procedures with regards to cost-effec-tiveness & efficacy in clearing medium-sized renal calculi (2.0 cms) at our institute. All costs borne by the patient & the institute were taken into account, including equip-ment costs, stay charges & cost of travel incurred, for re-peat visits to the institute. The groups compared had similar stone characteristics & were from our early experience with the two methods. All costing was done at 1998 rates by submitting case sheets to a fresh billing. PCNL, was significantly more efficient at clearing calculi (94% vs 69%) than ESWL, but patients needed hospitalization. The re-quirement of ancillary procedures was significantly less with PCNL than ESWL (1 vs 35) and ESWL was more expensive although the difference was not statistically sig-nificant. High initial cost of a lithotripter along with the need for repeated visits to the hospital for clearance of the calculus contribute to the increased cost of ESWL. PCNL ensures clearance of calculi at a single hospital admission with minimal morbidity.