Zekraoui Othmane, Moussa Ibrahim, Lee Nick, Nguyen David-Dan, Guennoun Abbas, Bouhadana David, Murad Liam, Siron Nicolas, Chen Kelven, Bhojani Naeem
Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
Division of Urology, Department of Surgery, Université de Montréal Health Center, Montreal, QC, Canada.
Int Urol Nephrol. 2025 Sep 15. doi: 10.1007/s11255-025-04784-9.
This systematic review compares the costs of common urolithiasis surgical options worldwide, identifies sources of heterogeneity in cost reporting, and propose recommendations for standardizing economic evaluations with the aim of reducing urolithiasis' financial burden globally.
We systematically searched Medline, EMBASE and Web of Science for studies published between 2014 and 2024. Included studies involved adult patients treated for a urolithiasis, described components of cost calculations, and provided a monetary value. Data was summarized qualitatively, and costs were first inflated, then converted to 2024 USD for comparability.
After identifying 2,461 references, 38 studies from 13 countries met the inclusion criteria. Variations in the definition of stone-free status were noted, with 17 studies not specifying it at all. While most studies accounted for procedural and hospital stay costs, the rest of the cost calculation components varied significantly. The costs of managing an episode with URS ranged from 249.12 to 48,937 USD, as for ESWL, the costs ranged from 177.48 to 10,184.64 USD. The costs of managing an episode using PCNL presented the largest disparity, ranging from 164.89 to 101,510.23 USD. Finally, studies assessing the management using MET reported costs from 293.89 to 17,982.19 USD.
Our review highlights substantial variability in urolithiasis treatment costs worldwide. Standardizing cost calculation methods and clinical success definitions is critical for guiding cost-effective decision-making and supporting evidence-based strategies to optimize resource allocation and reduce urolithiasis' financial burden globally.
本系统评价比较了全球常见尿石症手术方案的成本，确定成本报告中的异质性来源，并提出标准化经济评估的建议，以减轻全球尿石症的经济负担。
我们系统检索了Medline、EMBASE和科学网，查找2014年至2024年发表的研究。纳入的研究涉及接受尿石症治疗的成年患者，描述了成本计算的组成部分，并提供了货币价值。数据进行定性总结，成本首先进行通胀调整，然后转换为2024年美元以进行比较。
在识别出2461篇参考文献后，来自13个国家的38项研究符合纳入标准。注意到结石清除状态定义存在差异，17项研究根本未明确说明。虽然大多数研究考虑了手术和住院费用，但其余成本计算组成部分差异很大。输尿管镜碎石术（URS）治疗一次发作的成本在249.12美元至48937美元之间，体外冲击波碎石术（ESWL）的成本在177.48美元至10184.64美元之间。经皮肾镜取石术（PCNL）治疗一次发作的成本差异最大，在164.89美元至101510.23美元之间。最后，评估使用代谢疗法（MET）进行治疗的研究报告成本在293.89美元至17982.19美元之间。
我们的评价突出了全球尿石症治疗成本的巨大差异。标准化成本计算方法和临床成功定义对于指导成本效益决策以及支持优化资源分配和减轻全球尿石症经济负担的循证策略至关重要。
