Featured Research

from universities, journals, and other organizations

Non-invasive lithotripsy leads to more treatment for kidney stones, study finds

Date:
May 16, 2014
Source:
Duke University Medical Center
Summary:
When it comes to treating kidney stones, less invasive may not always be better, according to new research. In a direct comparison of shock wave lithotripsy vs. ureteroscopy -- the two predominant methods of removing kidney stones -- researchers found that ureteroscopy resulted in fewer repeat treatments.

When it comes to treating kidney stones, less invasive may not always be better, according to new research from Duke Medicine.

Related Articles


In a direct comparison of shock wave lithotripsy vs. ureteroscopy -- the two predominant methods of removing kidney stones -- researchers found that ureteroscopy resulted in fewer repeat treatments.

The findings were published May 16, 2014, in the journal JAMA Surgery, coinciding with presentation at the annual meeting of the American Urological Association.

"Nearly one out of 11 people in the United States has kidney stones, leading to more than $10 billion a year in treatment costs," said lead author Charles D. Scales Jr., M.D., assistant professor of surgery at Duke. "As we explore ways to improve value in the health care system, we need to look at the kinds of things that drive costs up; reducing the number of repeat procedures is one place to start."

Scales and colleagues analyzed data for nearly 48,000 insured patients in the United States who sought emergency room or urgent care treatment for kidney stones from 2002-10.

Roughly half the patients received shock wave lithotripsy, a non-invasive approach that focuses pressure waves on the stones to break them into tiny pieces that can then pass painlessly. The other half of patients underwent ureteroscopy, a minimally invasive procedure that uses a laser to break up the stone, and a thin scope that travels through the urethra to snare the stone in a small basket for removal.

Within 120 days of the initial procedure, approximately one in five of the patients needed a second treatment. The researchers focused their comparison on patients who were equally qualified for either procedure. Among that group, 11 percent of patients undergoing shock wave lithotripsy needed a second procedure, while less than 1 percent of ureteroscopy patients needed an additional treatment.

"Our findings add new insight, since most of published research around the effectiveness of the procedures was conducted years ago, when the technology was new," Scales said. In the past 20 years, he said, many experts believe shock wave lithotripsy has become less effective as the devices underwent design changes to improve safety. At the same time, ureteroscopy improved with better endoscopes and laser technology."

The researchers noted that the findings have important policy implications around Medicare reimbursements. For treating kidney stones, Medicare currently pays about $700 for a patient to receive lithotripsy, but only about $400 for a patient to receive the endoscopic ureteroscopy treatment, which the study found to be more effective.

The researchers suggested that differences in effectiveness, invasiveness and costs highlight important tradeoffs between the two procedures. In all cases, Scales said, the decision to undergo shock wave lithotripsy or ureteroscopy should be carefully considered by both the doctor and the patient.

"Many patients believe that because nothing is inserted into the body, shock wave lithotripsy is better, but that may not always be the case," Scales said. "There can be important tradeoffs for having the non-invasive procedure. One question to ask is about the likelihood of a second procedure, and the impact that might have on the cost of care and the time off work."


Story Source:

The above story is based on materials provided by Duke University Medical Center. Note: Materials may be edited for content and length.


Journal Reference:

  1. Charles D. Scales, Julie C. Lai, Andrew W. Dick, Jan M. Hanley, Jeroen van Meijgaard, Claude M. Setodji, Christopher S. Saigal. Comparative Effectiveness of Shock Wave Lithotripsy and Ureteroscopy for Treating Patients With Kidney Stones. JAMA Surgery, 2014; DOI: 10.1001/jamasurg.2014.336

Cite This Page:

Duke University Medical Center. "Non-invasive lithotripsy leads to more treatment for kidney stones, study finds." ScienceDaily. ScienceDaily, 16 May 2014. <www.sciencedaily.com/releases/2014/05/140516203230.htm>.
Duke University Medical Center. (2014, May 16). Non-invasive lithotripsy leads to more treatment for kidney stones, study finds. ScienceDaily. Retrieved March 27, 2015 from www.sciencedaily.com/releases/2014/05/140516203230.htm
Duke University Medical Center. "Non-invasive lithotripsy leads to more treatment for kidney stones, study finds." ScienceDaily. www.sciencedaily.com/releases/2014/05/140516203230.htm (accessed March 27, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Friday, March 27, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

House Ready to Pass Medicare Doc Bill

House Ready to Pass Medicare Doc Bill

AP (Mar. 26, 2015) In rare bipartisan harmony, congressional leaders pushed a $214 billion bill permanently blocking physician Medicare cuts toward House passage Thursday, moving lawmakers closer to resolving a problem that has plagued them for years. (March 26) Video provided by AP
Powered by NewsLook.com
HIV Outbreak Prompts Public Health Emergency In Indiana

HIV Outbreak Prompts Public Health Emergency In Indiana

Newsy (Mar. 26, 2015) Indiana Gov. Mike Pence says he will bring additional state resources to help stop the epidemic. Video provided by Newsy
Powered by NewsLook.com
Indiana Permits Needle Exchange as HIV Cases Skyrocket

Indiana Permits Needle Exchange as HIV Cases Skyrocket

Reuters - US Online Video (Mar. 26, 2015) Governor Mike Pence declares the recent HIV outbreak in rural Indiana a "public health emergency" and authorizes a short-term needle-exchange program. Rough Cut (no reporter narration) Video provided by Reuters
Powered by NewsLook.com
AAA: Distracted Driving a Serious Teen Problem

AAA: Distracted Driving a Serious Teen Problem

AP (Mar. 25, 2015) While distracted driving is not a new problem for teens, new research from the AAA Foundation for Traffic Safety says it&apos;s much more serious than previously thought. (March 25) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins