AUA 2017: Percutaneous Access Obtained by Urologist is Associated with Decreased Complications, Shorter Length of Stay, and Lower Hospital Costs in PCNL

Boston, MA ( Dr. Korets and colleagues investigated cost characteristics of radiologist versus urologist-mediated access in percutaneous nephrolithotomy. Data was collected from a national database of more than 40,000 patients.

They found that urologists were more likely to obtain access at large hospitals and teaching institutions. Greater or equal to 10 cases improved the rate of successful access by for the urologist by 18%. Median cost of obtaining access by the urologist was lower by 9% compared to access by a radiologist. Importantly, a limitation of the study was the lack of accessible information on stone characteristics and outcomes of treated stone disease in the two experimental groups.

Following the presentation, Dr. Korets reported that the primary outcomes were controlled for all covariates (age, gender, Charlson Co-morbidity Index, etc.). An interesting and important point raised by comments focused on the premise that any physician should improve with more experience of a procedure. Thus, we should expect that a more experienced urologist would show improved access. An interesting and necessary follow-up study to fully address their hypothesis would ask if a poorly trained urologist or radiologist is worse at gaining access, and if the lack-of training is comparable as well.

Presented by: by Dr. Ruslan Korets, MD

Authors: : Ruslan Korets, Jacqueline M. Speed, Ye Wang, Steven L. Chang

Affiliation: Boston, MA

Written By: Daniel Lama for

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA