Improved cost-effectiveness and efficiency with a slower shockwave delivery rate.

Area of Science:

• Urology
• Nephrology
• Medical Devices

Background:

• Extracorporeal shockwave lithotripsy (ESWL) is a common treatment for kidney stones.
• Optimizing shockwave (SW) delivery rate is crucial for treatment efficiency and cost-effectiveness.

Purpose of the Study:

• To evaluate the impact of a slower SW delivery rate (70 shocks/min) on ESWL treatment efficiency and cost.
• To compare a slow SW rate with a faster rate (100 shocks/min) in a clinical setting.

Main Methods:

• A comparative study involving 102 patients with upper urinary tract radio-opaque calculi undergoing ESWL.
• Patients were divided into two groups: slow (70 SW/min) and fast (100 SW/min) SW delivery rates.
• Outcomes assessed included stone-free rate, re-treatment rate, additional procedures, and both perceived and actual costs over a > or = 6-month follow-up.

Main Results:

• The slow SW rate group demonstrated a significantly higher stone-free rate (67% vs 25.5%) and a lower re-treatment rate (22% vs 45%).
• Fewer mean shocks were required for clinical success in the slow group (3045 vs 4414), with a greater efficiency quotient (0.51 vs 0.16).
• The actual cost of treatment was significantly reduced by half in the slow group (496 pounds vs 1002 pounds).

Conclusions:

• Reducing the SW delivery rate to 70/min significantly enhances ESWL treatment efficiency.
• A slower SW delivery rate substantially decreases the overall cost of ESWL while improving clinical outcomes.