RESUMEN
This health economic evaluation simulated a cohort to compare hydrophilic-coated to non-coated catheters for intermittent catheterization. By using a Markov model, lifetime costs and catheter-related complications were investigated. Results determined that the use of hydrophilic-coated catheters save money and reduce treatment-related complications.
Asunto(s)
Bacteriemia/epidemiología , Infecciones Relacionadas con Catéteres/epidemiología , Epididimitis/epidemiología , Costos de la Atención en Salud , Estrechez Uretral/epidemiología , Cálculos de la Vejiga Urinaria/epidemiología , Vejiga Urinaria Neurogénica/enfermería , Cateterismo Urinario/métodos , Catéteres Urinarios/economía , Infecciones Urinarias/epidemiología , Adulto , Anciano , Bacteriemia/economía , Infecciones Relacionadas con Catéteres/economía , Estudios de Cohortes , Epididimitis/economía , Femenino , Humanos , Masculino , Cadenas de Markov , Persona de Mediana Edad , Modelos Económicos , Autocuidado , Estados Unidos , Estrechez Uretral/economía , Cálculos de la Vejiga Urinaria/economía , Cateterismo Urinario/instrumentación , Infecciones Urinarias/economía , Adulto JovenRESUMEN
Laser lithotripsy does not play an important role in urinary stone treatment, mostly due to ineffective fragmentation efficiency, and high purchase and maintenance costs. The aim of the following retrospective study was to show the clinical significance and efficiency of an innovative laser lithotripsy system for urinary stone treatment. Between November 1998 and October 1999, 48 patients were treated with the innovative frequency- doubled double-pulse Neodym: YAG laser lithotripter FREDDY. A total of 50 renal units were treated, 43 ureteroscopically, four ureterorenoscopically, three percutaneous-nephroscopically, and one bladder stone cystoscopically. With a median laser operation time of 5 min (range: 1-30 min) and a total procedure duration of 60 min (range: 15-180 min), a stone-free rate of upper ureteral stones of 62%, middle ureteral stones of 91% and distal ureteral stones of 100% were documented on the first day after treatment. In an observation period of 6 months, no complications were seen. In our experience Laser lithotripsy with FREDDY is an effective, simple and reliable method for the treatment of ureteral stones, with low purchase and maintenance costs. The extremely thin and highly flexible quartz fibre may extend the endoscopic spectrum to otherwise poorly accessible upper ureteral stones, the renal pelvis and renal calix stones. Therefore, a prospective validation study for comparison with ballistic lithotriptors is of great interest.