Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Comparison of the Effectiveness and Financial Aspects of Emergent Ureterorenoscopy and Elective Ureterorenoscopy in Patients with Symptomatic Ureteral Calculi
Akut ve Elektif Üreteroskopinin Semptomatik Üreter Taşlarında Etkinlik ve Finansal Yönlerinin Değerlendirilmesi
Cumhur YEŞİLDALa, Ahmet Kenan KARADEMİRb, Hasan SOYDANc , Ferhat ATEŞa, Ercan MALKOÇa, Ömer YILMAZa, Ahmet Tevfik ALBAYRAKc, Güven OYSULd, Temuçin ŞENKULe
aDepartment of Urology, University of Health and Sciences Sultan Abdulhamid Han Training and Research Hospital İstanbul, TURKEY
bDepartment of Urology, Maltepe University Faculty of Medicine, İstanbul, TURKEY
cDepartment of Urology, University of Health Sciences Şisli Hamidiye Etfal Training and Research Hospital, İstanbul, TURKEY
dMinistry of National Defense General Directorate of Military Health Services, Ankara, TURKEY
eClinic of Urology, VM Medical Park Maltepe Hospital, İstanbul, TURKEY
J Reconstr Urol. 2020;10(3):69-74
doi: 10.5336/urology.2020-75895
Article Language: EN
Full Text
ABSTRACT
 Objective: In this study, we aimed to compare the efficacy, complications, and financial aspects of urgent ureteroscopy (URS) with elective URS in patients who applied with the acute flank pain caused by ureteral calculi. Material and Methods: The records of 70 adult patients, who applied to the emergency and urology department at Gata Haydarpasa Research and Training Hospital between June 2012 and May 2014 evaluated prospectively. Patients were divided into two group including the patients with colic pain that had started within 12 hours before admission who also agreed to be operated urgently (Group 1: acute URS) and the patients who requested the necessary intervention only if spontaneous passage cannot be provided (Group 2: elective URS). Kidney, ureter, bladder radiography (KUB), and urinary ultrasonography (USG) were applied to all patients. A total of 16 urgent and 19 elective URSs were performed. Results: The average treatment cost of the urgent URS patients was found to be 855.00 TL (143.78 ?) per payment, and the average treatment cost of the elective URS patients was found to be 979.00 TL (164.63 ?) (p<0.001) per patient. These results were statistically significant. Conclusion: Urgent URS is a treatment modality that requires minimal additional treatment. Besides, the patients can turn back to their social activities earlier, and it also reduces the psychological side-effects of urolithiasis. Although the superiority of one method over another cannot be concluded with this study, the application of urgent URS costs less compared to elective URS.

Keywords: Ureteral calculi; endoscopy; emergency treatment; elective surgical procedures, treatment outcome
ÖZET
 Amaç: Bu çalışmada akut böbrek koliği nedeniyle başvuran üreter taşlı hastalarda acil üreteroskopinin (URS), elektif URS ile etkinlik, komplikasyon ve finansal yönlerini karşılaştırmayı amaçladık. Gereç ve Yöntemler: Haziran 2012-Mayıs 2014 tarihleri arasında Gata Haydarpaşa Eğitim ve Araştırma Hastanesinde acil ve üroloji bölümüne başvuran 70 yetişkin hastanın kayıtları prospektif olarak değerlendirildi. Hastalar iki gruba ayrıldı. Grup 1 (akut URS): kolik ağrısı başvurudan önce 12 saat içinde başlamış ve acil olarak ameliyat olmayı kabul eden hastalar. Grup 2 (elektif URS): Spontan taşlarını düşüremeyip elektif ameliyat olmak hastalar. Tüm hastalara direkt grafi ve üriner ultrasonografi uyguladı. Toplamda 16 acil, 19 elektif URS vakası değerlendirilip karşılaştırıldık. Bulgular: Acil URS hastalarının ortalama tedavi maliyeti ödeme başına 855,00 TL (143,78 ?), elektif URS hastalarının ortalama tedavi maliyeti 979,00 TL (164,63 ?) olarak bulundu (p<0,001). Bu sonuçlar istatistiksel olarak anlamlıydı. Sonuç: Akut URS ile hastaların ek tedavi ihtiyacı azalmakta ve daha hızlı sosyal aktivitelerine geri dönebilmektedir. Böylelikle taş hastalığının oluşturduğu psikolojik yan etkiler de en düşük seviyeye inmektedir. Her ne kadar akut ve elektif URS etkinlik olarak istatiksel fark göstermese de akut URS daha düşük maliyet profili ile dikkat çekmektedir.

Anahtar Kelimeler: Üreter taşları; endoskopi; acil tedavi; elektif cerrahi işlemler; tedavi sonucu
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