Background and Objective: The cost of imaging and interventions in the surgical field varies between countries and sometimes within different regions of the same country. Procedural cost takes into account equipment, consumables, operating room, surgical, anesthetic and nursing teams, radiology, medications, and hospital stay. Health care systems therefore face an incredible burden related to investigations and surgical procedures. The aim of this study was to collect costs of imaging and interventions for kidney calculi across different hospitals and health care systems in the world. Methods: An online shared Google spreadsheet was created by the European Association of Urology Young Academic Urology urolithiasis group. The survey consisted of the cost of four radiological imaging (ultrasound of the urinary tract [USS], plain X-ray radiography of the abdomen including kidneys, ureter, and bladder [XRKUB], noncontrast-enhanced computerized tomography [CTKUB], and contrast-enhanced CT with urographic phase [CTU]) and seven interventions (endoscopic laser treatment of renal stones, ureteroscopic treatment or extraction of ureteral stones, percutaneous nephrolithotomy (PCNL), insertion of ureteral stent, diagnostic ureteroscopy, and cystolitholapaxy). A chosen representative from each country collected and collated the data, and this was converted to Euros (€). Key Findings and Limitations: Data were collected from 32 countries, which include Turkey, Armenia, Nepal, Uzbekistan, Brazil, Chile, Qatar, Peru, Israel, Singapore, Thailand, Colombia, Argentina, Saudi Arabia, Asia, North America, 15 countries from the European continent, and the United States. The mean cost of USS, XRKUB, CTKUB, and CTU was 51.3 € (range: 2-160 €), 27.1 € (range: 2.5-187 €), 105.8 € (range: 19-405 €), and 171.5 € (range: 19-674 €), respectively. Similarly, the cost of endoscopic laser treatment of renal stones, ureteroscopic treatment/extraction of ureteral stones, PCNL, insertion of ureteral stent, diagnostic ureteroscopy, and cystolitholapaxy was 1942.6 € (range: 100-7887 €), 1626.8 € (range: 80-9787 €), 2884.6 € (range: 110-12642 €), 631 € (range: 110-2787 €), 861.6 € (range: 3-2667 €), and 876 € (range: 19-3457 €), respectively. Wide differences in cost between countries were found within the study. Conclusions and Clinical Implications: This study highlights the significant economic impact of kidney stone management on health care systems worldwide. There seem to be significant disparities between costs, and this study shows the social and economic inequalities in health care access, which can differ significantly between private and public health care. These results can aid policymakers to address these disparities and perhaps to learn from other health care providers.
Journal of endourology. 2025 Feb 28 [Epub ahead of print]
Amelia Pietropaolo, Etienne Xavier Keller, Tarik Emre Sener, B M Zeeshan Hamed, Arman Tsaturyan, Eugenio Ventimiglia, Patrick Juliebø-Jones, Christian Beisland, Ioannis Mikoniatis, Lazaros Tzelves, Vincent De Coninck, Frederic Panthier, Michael Chaloupka, Ewa Bres-Niewada, Alba Sierra Del Rio, Laurian Dragos, Nariman Gadzhiev, Anil Shrestha, Azimdjon Tursunkulov, Khurshid R Ghani, Chinnakhet Ketsuwan, Alexandre Danilovic, Felipe Pauchard, Hatem Kamkoum, Johan Cabrera, Mariela Corrales, Yazeed Barghouthy, Jia-Lun Kwok, Theodoros Tokas, Catalina Solano, Pablo Nicolas Contreras, Saeed Bin Hamri, Naeem Bhojani, A Carolien Bouma-Houwert, Thomas Tailly, Otas Durutovic, Bhaskar K Somani
Urology, University Hospital Southampton, Southampton, United Kingdom., Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Urology, Marmara University School of Medicine, Istanbul, Türkiye., Urology, Father Muller Medical College, Mangalore, India., Urology, Erebouni Medical Center, Erebouni, Armenia., Urology, IRCCS Ospedale San Raffaele, Milan, Italy., Department of Urology, Haukeland University Hospital Bergen, Norway, and Department of Clinical Medicine, University of Bergen, Bergen, Norway., Urology, Aristotle University, Thessaloniki, Greece., Urology, National and Kapodistrian University of Athens, Athens, Greece., Urology, AZ Klina, Brasschaat, Belgium., Urology, GRC 20-Sorbonne University Tenon Hospital, Paris, France., Urology, University Hospital LMU Munich, Munich, Germany., Urology, Faculty of Medicine Lazarski University Warsaw, Warsaw, Poland., Urology, Hospital Clinic de Barcelona, Barcelona, Spain., Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom., Urology, Saint-Petersburg State University Hospital, Saint Petersburg, Russia., Urology, National Academy of Medical Sciences, Gwarko Lalitpur, Nepal., Urology, AkfaMedline Hospital, Tashkent, Uzbekistan., Urology, University of Michigan, Michigan, USA., Urology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil., Urology, Hospital Naval Almirante Nef, Vina del Mar, Chile., Urology, Hamad Medical Corporation, Doha, Qatar., Department of Urology, Javier Prado Clinic, Lima, Peru., Urology, Assistance-Publique Hopitaux de Paris Hopital Tenon Sorbonne Université, Paris, France., Hospital Européen Georges Pompidou-APHP, Urology and Transplantation Department, Paris, France., Department of Urology, Medical School, University General Hospital of Heraklion, University of Crete, Heraklion, Greece., Urology, Uroclin S.A.S Medellín Colombia, Medellin, Colombia., Urology, Hospital Aleman Buenos Aires Argentina, Buenos Aires Argentina, Argentina., Urology, Urology Department at Specialized Medical Center SMC2 Riyadh Saudi Arabia, Riyadh, Saudi Arabia., Urology, Division of Urology, University of Montréal, Montreal, Canada., Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands., University Hospital Ghent, Ghent, Belgium., Urology, Clinic of Urology UCCS, Belgrade, Serbia.