MP08-18 THE TREATMENT OF 15-20 MM RENAL CALCULI: A COST-UTILITY ANALYSIS COMPARING FLEXIBLE URETEROSCOPY WITH PERCUTANEOUS NEPHROLITHOTRIPSY

INTRODUCTION AND OBJECTIVES:Treatment options for renal calculi are well established for smaller stones ( 20mm). Smaller stones are often treated with surveillance, shockwave lithotripsy, or flexible ureteroscopy (URS) while calculi larger than 20 mm are typically treated with percutaneous nephrolithotripsy (PCNL). Treatment guidelines for renal calculi in the transition zone with stone sizes that approach 20 mm are not as well defined. The objective of this study was to compare ureteroscopic laser lithotripsy to PCNL for the treatment of renal calculi measuring 15-20 mm and to determine which of these two would be the preferred treatment considering cost and patient preferences (utilities).METHODS:The cost and utilities of URS and PCNL were compared for the treatment of 15-20 mm renal calculi using a cost-utility decision analysis model. Probability estimates were derived from the literature. Direct third-party payer costs were determined in Canadian dollars and obtained from D...