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598 DEFINING THE FACTORS INFLUENCING THE DECISION ON POST-URETEROSCOPIC STENTING: A MULTIVARIATE ANALYSIS
FDEOHDQGWKHFDPHUDKHDGDUHDVVHPEOHGLQDQRQVWHULOHPDQQHURQDWKUHHMRLQW DUP QHDU WKH RSHUDWLQJ WDEOH PDNLQJ WKH VFRSH OLJKWZHLJKW DQG HDV\ WR KDQGOH $QJOHVRIPD[LPXPDFWLYHGHᚐHFWLRQLUULJDWLRQᚐRZDQGRSWLFDOFKDUDFWHULVWLFVOLNH RSWLFDOUHVROXWLRQDQGGLVWRUWLRQᚏHOGDQGDQJOHRIYLHZZHUHGHWHUPLQHGLQDQH[ YLYRODERUDWRU\VHWWLQJ7KHFOLQLFDOSHUIRUPDQFHZDVHYDOXDWHGLQDFRKRUWRI SDWLHQWVLQDWRWDORIFRQVHFXWLYHXUHWHURVFRSLFSURFHGXUHVIRUWKHPDQDJHPHQW RILQWUDUHQDOFDOFXOL Results: )RUWKH&K3RO\6FRSHpWKHPD[LPXPGHᚐHFWLRQDQJOHZLWKDQHPSW\ ZRUNLQJFKDQQHOZDVDVPXFKDVrZLWKDQLQVHUWHGwPODVHUᚏEUHRUD )'RUPLDEDVNHWGHᚐHFWLRQDQJOHVDVPXFKDVr7KHLQVHUWLRQRIHQGRXURORJLF WRROVOLNH˩PDQG˩PODVHUᚏEHUVRUDQG&KEDVNHWVKDGQHJDWLYH LPSDFWV RQ LUULJDQW ᚐRZ SURSHUWLHV LQ D UDQJH EHWZHHQ DQG 2Q D[LV DQG RᚎD[LV UHVROXWLRQ \LHOGHG DQG OLQH SDLUVPP WKH RSWLFDO UHVROXWLRQWKHᚏHOGRIYLHZ rDQGWKHGLUHFWLRQRIYLHZr3UHOLPLQDU\ FOLQLFDOUHVXOWVVKRZHGFRPSOHWHLQWUDUHQDODFFHVVLQRISDWLHQWVZLWKDPHDQ RSHUDWLYHWLPHRIsPLQXWHV6WRQHIUHHUDWHDIWHUPRQWKVZDV LQ WKLV VHULHV ,Q SDWLHQWV WKH 3RO\6FRSHp FDWKHWHU KDG WR EH H[FKDQJHG LQWUD RSHUDWLYHO\GXHWREUHDNDJHRIWKHVWHHULQJPHFKDQLVPLQWKHKDQGKHOG Conclusions: 7KH GHYHORSPHQW RI D PRGXODU GHVLJQ VHPLGLVSRVDEOH ᚐH[LEOH XUHWHURUHQRVFRSHZLWKDUHXVDEOHRSWLFDOV\VWHPPLJKWGLPLQLVKWKHGLVDGYDQWDJHV RIFRPPRQ)85VOLNHWKHLUYXOQHUDELOLW\ZLWKFRQVHFXWLYHO\KLJKUHSDLUIUHTXHQFLHV DQGUXQQLQJFRVWV)XUWKHUGHYHORSPHQWDQGLQLWLDOPXOWLFHQWHUVWXGLHVZLOOGHWHUPLQH WKHFOLQLFDOYDOXHDQGH[WHQVLRQRIWKH3RO\6FRSHpV\VWHPLQWKHQHDUHUIXWXUH
598
DEFINING THE FACTORS INFLUENCING THE DECISION ON POST-URETEROSCOPIC STENTING: A MULTIVARIATE ANALYSIS
.HUHQ3D]*0DEMHHVK1-*UHHQVWHLQ$%HQ&KDLP-0DW]NLQ+6RIHU0 Tel-Aviv Sourasky Medical Center, Dept. of Urology, Tel-Aviv, Israel Introduction & Objectives: 7R LGHQWLI\ IDFWRUV LQᚐXHQFLQJ WKH GUDLQDJH RSWLRQ DIWHUXUHWHURVFRSLFSURFHGXUHV Material & Methods: 7KHVWXG\FRPSULVHVDFRQVHFXWLYHVHULHVRISDWLHQWV UHIHUUHG IRU UHWURJUDGH HQGRVFRSLF WUHDWPHQW RI VWRQH GLVHDVH ,QWHUQDO VWHQWV ZHUHOHIWSRVWRSHUDWLYHO\LQ SDWLHQWV VWHQWHGJURXS DQGHLWKHURYHUQLJKW XUHWHUDO FDWKHWHU RU QR GUDLQDJH ZHUH FKRVHQ LQ SDWLHQWV QRQVWHQWHG JURXS 'HPRJUDSKLFFOLQLFDODQGLQWUDRSHUDWLYHGDWDZHUHVWDWLVWLFDOO\DVVHVVHG Results: 8UHWHURVFRS\ 856 UHWURJUDGH QHSKURVFRS\ 51 DQG FRPELQHG 856 DQG 51V ZHUH SHUIRUPHG LQ DQG SDWLHQWV UHVSHFWLYHO\ %LODWHUDO SURFHGXUHV ZHUH SHUIRUPHG LQ SDWLHQWV 8QLYDULDWH DQDO\VLV GHPRQVWUDWHG WKDW VLJQLᚏFDQW SURJQRVWLFDWRUV IRU QRQVWHQWLQJ GHFLVLRQ DUH VWRQHVL]H PP S SUHYLRXVHQGRVFRSLFWUHDWPHQW 25S SUHRSHUDWLYHLQWHUQDOVWHQW 25S RSHUDWLYHWLPH PLQ S VXUJHRQH[SHULHQFH S EDVNHWVWRQHUHPRYDO 25S QRVWRQH 25S 6LJQLᚏFDQWSURJQRVWLFDWRUVIRUVWHQWLQJZHUHVWRQHVL]Hุ PP 25S SUHYLRXV6:/ 25S KROPLXPODVHUIUDJPHQWDWLRQ 25S DQGRSHUDWLYHWLPHุPLQ 25 S $JHJHQGHU RSHUDWLRQ W\SH VWRQH ORFDWLRQ DQG ELODWHUDOLVP GLG QRW VLJQLᚏFDQWO\ LQᚐXHQFH WKH GHFLVLRQIRUSRVWRSHUDWLYHVWHQWLQJ0XOWLYDULDWHDQDO\VLVGHPRQVWUDWHGWKDWSUHYLRXV WUHDWPHQWSUHRSHUDWLYHLQWHUQDOVWHQWRSHUDWLYHWLPHDQGVXUJHRQH[SHULHQFHDUH LQGHSHQGHQWSURJQRVWLFDWRUVRIWKHFKRLFHRISRVWRSHUDWLYHGUDLQDJH Conclusions: 7KH FKRLFH RI GUDLQDJH DIWHU UHWURJUDGH HQGRVFRSLF SURFHGXUHV LV LQGHSHQGHQWO\ LQᚐXHQFHG E\ SUHYLRXV WUHDWPHQW SUHRSHUDWLYH LQWHUQDO VWHQW RSHUDWLYHWLPHDQGVXUJHRQH[SHULHQFH7KHVHᚏQGLQJVPLJKWKHOSLQWKHGHFLVLRQ PDNLQJ SURFHVV DERXW WKH W\SH RI SRVWRSHUDWLYH GUDLQDJH KHOSLQJ LQ LPSURYLQJ WUHDWPHQWHᚑFLHQF\DQGLQGHFUHDVLQJVHFRQGDU\PRUELGLW\
599
URETEROSCOPY IN PREGNANT WOMEN WITH CLINICALLY ACUTE URETERAL OBSTRUCTION
8OYLN2+ºVWPDUN-*%DNNH$0*MHQJVWº37RUNHOVHQ7.8OYLN10 Haukeland University Hospital, Dept. of Urology, Bergen, Norway Introduction & Objectives: ,Q ZH LQWURGXFHG D SURJUDPPH IRU GLDJQRVLV REVHUYDWLRQ DQG WUHDWPHQW RI SUHJQDQW ZRPHQ ZLWK DFXWH ᚐDQN SDLQ LQGLFDWLQJ XUHWHUDO REVWUXFWLRQ ,I WKH SDLQ ZDV VHYHUH HQRXJK WR UHTXLUH RSLRLG PHGLFDWLRQ IRUPRUHWKDQGD\VXUHWHURVFRS\ZDVRᚎHUHGERWKIRUGLDJQRVLVDQGWUHDWPHQW RIWKHVXVSHFWHGREVWUXFWLRQ:HUHSRUWRXUH[SHULHQFHVZLWKXUHWHURVFRS\LQWKLV VLWXDWLRQ Material & Methods: 7KHGLDJQRVLVRIDFXWHXUHWHUDOREVWUXFWLRQZDVEDVHGRQ KLVWRU\DQGSK\VLFDOH[DPLQDWLRQEORRGDQDO\VLVXULQHDQDO\VLVDQG86H[DPLQDWLRQ RINLGQH\DQGEODGGHU;UD\H[DPLQDWLRQVZHUHDYRLGHG,IVHYHUHDFXWHᚐDQNSDLQ ZDVVHHQZLWKXSSHUXULQDU\WUDFWLQIHFWLRQRULPSDLUHGUHQDOIXQFWLRQXUHWHURVFRS\ ZDVSHUIRUPHGZLWKRXWGHOD\$WRWDORIXUHWHURVFRSLHVKDYHEHHQSHUIRUPHG GXULQJ SUHJQDQFLHVLQZRPHQZLWKVHPLULJLGLQVWUXPHQWVLQHLWKHUJHQHUDO UHJLRQDORUWRSLFDODQHVWKHVLDFRPELQHGZLWKOLJKWVHGDWLRQ Results: 8UHWHURVFRS\FRXOGEHSHUIRUPHGLQDOOFDVHVHYHQLQWKHWKLUGWULPHVWHU 8UHWHUDO VWRQHV ZHUH IRXQG LQ RI XUHWHURVFRSLHV SHUIRUPHG IRU VXVSHFWHG XUHWHUDOVWRQHVHGHPDLQWKHORZHUXUHWHUZLWKRXWDQ\VWRQHLQS\RQHSKURVLVLQ EORRGFORWVLQWKHUHQDOSHOYLVLQDQGPHJDORXUHWHULQ7ZRDGGLWLRQDOSDWLHQWV KDG 83- REVWUXFWLRQ GLDJQRVHG EHIRUH WKH SUHJQDQF\ 7KH HQGRVFRSLF ᚏQGLQJV
ZHUHQRUPDOLQFDVHVSDWLHQWVQHHGHGPRUHWKDQXUHWHURVFRS\GXULQJWKH VDPHSUHJQDQF\ 2QHSDWLHQWH[SHULHQFHGVWRQHREVWUXFWLRQRIWKHOHIWXUHWHUDQG VRPHZHHNVODWHURIWKHULJKWXUHWHU2QHSDWLHQWKDGXUHWHURVFRSLHVWRWUHDWERWK DQREVWUXFWLQJVWRQHDQGDFDOFLᚏHG--VWHQW2QHSDWLHQWZDVWUHDWHGDVHFRQG WLPHIRUDGLVORFDWHG--VWHQW2QHSDWLHQWKDGWZRXUHWHURVFRSLHVIRUXQH[SODLQHG ORQJVWDQGLQJXUHWHUDOREVWUXFWLRQZLWKXSSHUXULQDU\WUDFWLQIHFWLRQLQLWLDOO\GUDLQHG ZLWKDSHUFXWDQHRXVQHSKURVWRP\WXEHSDWLHQWVQHHGHGXUHWHURVFRS\IRUFOLQLFDOO\ VXVSHFWHGXUHWHUDOREVWUXFWLRQLQDQGGLᚎHUHQWSUHJQDQFLHVUHVSHFWLYHO\7KHUH ZHUH QRUPDO GHOLYHULHV FHVDUHDQ VHFWLRQV VHYHQ ZHHNV SUHPDWXUH GHOLYHU\HOHFWLYHWHUPLQDWLRQXQUHODWHGWRXUHWHURVFRS\DQGXQNQRZQ7KH SUHJQDQFLHVUHVXOWHGLQQRUPDOEDELHVLQFOXGLQJWZLQFRXSOHV,QDGGLWLRQ FKLOGZDVERUQZLWKFOHIWOLSSDODWHZLWKPLOGFHUHEUDOSDOV\DQGXQNQRZQ Conclusions: 8UHWHURVFRS\ZLWKVHPLULJLGLQVWUXPHQWVLVVDIHDQGHᚎHFWLYHDQG VKRXOGUHSODFHRWKHULQYDVLYHWUHDWPHQWPRGDOLWLHVLQPRVWSUHJQDQWZRPHQZLWK FOLQLFDOO\VXVSHFWHGVHYHUHXUHWHUDOREVWUXFWLRQ
600
COST ANALYSIS OF FLEXIBLE URETERORENOSCOPY AFTER 630 INTERVENTIONS
/LVNH32EHU3$JXLODU<=LPPHUPDQQV9/DKPH6 Siloah St. Trudpert Hospital, Dept. of Urology, Pforzheim, Germany Introduction & Objectives: )OH[LEOHXUHWHURUHQRVFRS\SOD\VDQLPSRUWDQWUROHLQ WKHWUHDWPHQWRIXSSHUXULQDU\WUDFWGLVHDVHV'XHWRWKHXVHDQGWHFKQLFDOZHDU RIᚐH[LEOHVFRSHVHYHU\SURFHGXUHFDXVHVDGGLWLRQDOFRVWV)UHTXHQF\DQGFRVWV RIUHSDLUZHUHDQDO\VHG Material & Methods: FRQVHFXWLYH ᚐH[LEOH XUHWHURUHQRVFRSLF SURFHGXUHV ZHUH HYDOXDWHG ,Q DOO FDVHV DQ XUHWHUDO DFFHVV VKHDWK ZDV XVHG ,Q FDVHV UHQDOSHOYLFRUFDO\FHDOVWRQHVZHUHWUHDWHG,QFDVHVKROPLXPODVHUOLWKRWU\SV\ wP ᚏEUH ZDV XVHG ,Q WRWDO WKH SURFHGXUHV ZHUH SHUIRUPHG E\ ᚐH[LEOH XUHWHURVFRSHV 9LSHU5LFKDUG:ROI&RPSDQ\.QLWWOLQJHQ*HUPDQ\ Results: ,Q WRWDO UHSDLUV ZHUH QHFHVVDU\ LQ LQVWUXPHQWV 7RWDO FRVWV RI UHSDLU ZHUH HXUR 7KH PHDQ FRVWV SHU SURFHGXUH ZHUH HXUR 7KHDYHUDJHGXUDELOLW\RIHDFKLQVWUXPHQWZDV SURFHGXUHV5HSDLURIᚐH[LEOH VFRSHV ZDV QHFHVVDU\ GXH WR DOWHUDWLRQ RI WKH ZRUNLQJ FKDQQHO WKH ZLUHV IRU GHᚐHFWLRQDOWHUDWLRQRIWKHVFRSHvVVXUIDFHDQGEUHDNRIRSWLFDOᚏEUHV'DPDJHV ZHUHFDXVHGE\XVHRIKROPLXPODVHUGXULQJRSHUDWLRQVWHULOLVDWLRQSURFHVVDQG WUDQVSRUWDWLRQ Conclusions: )OH[LEOH XUHWHURUHQRVFRS\ LV DVVRFLDWHG ZLWK DGGLWLRQDO FRVWV GXH WR WKH IUDJLOLW\ RI LQVWUXPHQWV 7KHVH FRVWV RI UHSDLU DUH DFFHSWDEOH DV WKH\ RQO\ DFFRXQWIRUDPLQRUSDUWRIWKHUHLPEXUVHPHQW%HFDXVHRIWKHVKRUWHUWUHDWPHQW WLPHORZHUUHWUHDWPHQWUDWHDQGKLJKHUVWRQHIUHHUDWHWKDQVKRFNZDYHOLWKRWULSV\ LW LV FRVWHᚎHFWLYH WR XVH ᚐH[LEOH XUHWHURUHQRVFRS\ LQ HQGRXURORJLFDO VWRQH WUHDWPHQW
601
EFFICIENCY AND MORBIDITY OF FLEXIBLE URETERONEPHROSCOPY IN OBESE PATIENTS
'HORUPH*1JX\HQ+XX<*XLOODXPH*&KDEDQQHV(%HUQDUGLQL6 /RRFN3<%LWWDUG+.OHLQFODXVV. University Hospital Saint-Jacques, University of Franche-Comté, Dept. of Urology and Renal Transplantation, Besançon, France Introduction & Objectives: 0DQ\UHWULHYDOPHWKRGVIRUXULQDU\VWRQHVVXFKDV H[WUDFRUSRUHDO VKRFN ZDYH OLWKRWULSV\ (6:/ RU SHUFXWDQHRXV QHSKUROLWKRWRP\ DUHDVVRFLDWHGZLWKSRRUUHVXOWVDQGLQFUHDVHGPRUELGLW\LQREHVHSDWLHQWVZLWKD ERG\PDVVLQGH[ %0, VXSHULRUWRNJP7KHDLPRIWKHVWXG\ZDVWRDQDO\]H UHVXOWV DQG PRUELGLW\ RI ᚐH[LEOH XUHWHURQHSKURVFRS\ LQ REHVH SDWLHQWV DQG WR FRPSDUHZLWKUHVXOWVREWDLQHGLQQRQREHVHSDWLHQWV Material & Methods: :H FRQGXFWHG D UHWURVSHFWLYH VWXG\ LQFOXGLQJ DOO ᚐH[LEOH XUHWHURQHSKURVFRS\ SURFHGXUHV SHUIRUPHG IRU VWRQHV UHWULHYDO LQ RXU LQVWLWXWLRQ EHWZHHQ-DQXDU\DQG'HFHPEHU'XULQJWKHVWXG\SHULRGᚐH[LEOH XUHWHURQHSKURVFRS\ ZHUH SHUIRUPHG IRU VWRQHV UHWULHYDO FRQFHUQHG REHVH SDWLHQWV ZLWK %0,! NJP FRQFHUQHG QRQ REHVH SDWLHQWV DQG IRU SURFHGXUHVGDWDUHJDUGLQJ%0,ZHUHQRWDYDLODEOH'DWDFRQFHUQLQJSDWLHQWV $JH %0, SUHYLRXV WUHDWPHQW VWRQH QDWXUH ORFDWLRQ QXPEHU SURFHGXUH RSHUDWLQJ WLPHPRUELGLW\UHVXOWV ZHUHH[WUDFWHGIURPSDWLHQWFKDUWVLQFOXGHGLQDGDWDEDVH DQGDQDO\]HG)ROORZXSZDVSHUIRUPHGDWDQGPRQWKV6XFFHVVZDVGHᚏQHG E\FOHDULPDJLQJ FRPSOHWHVWRQHIUHH DWUHQDOWRPRJUDSK\DQGXOWUDVRQRJUDSK\ Results: 0HDQ%0,ZDVNJPLQJURXS 2EHVHSDWLHQWV DQGNJ PLQJURXS 1RQREHVHSDWLHQWV $SUHYLRXVWUHDWPHQWIRUVWRQHIUDJPHQWDWLRQ RUUHWULHYDOZDVSHUIRUPHGDQGUHVXOWHGLQUHVLGXDOIUDJPHQWVLQLQJURXS DQGLQJURXS S $SUHYLRXV(6:/ZDVDIDLOXUHLQDQGLQ JURXSDQGUHVSHFWLYHO\0HDQVWRQHVL]H PPLQJURXSYV PPLQJURXSS 16 VWRQHORFDWLRQ ORZHUSROHLQJURXSYVLQ JURXSS 16 DQGVWRQHQDWXUHZDVQRWGLᚎHUHQWLQERWKJURXSV2SHUDWLQJWLPH ZDVVLPLODULQJURXSDQGJURXS PLQYVPLQS 16 7KH UDWHRIPLQRUFRPSOLFDWLRQV IHYHUKHPDWXULDᚐDQFNSDLQ ZDVQRWKLJKHULQREHVH SDWLHQWV WKDQ LQ QRQ REHVH SDWLHQWV 1R PDMRU FRPSOLFDWLRQV UHTXLULQJSURORQJHGKRVSLWDOVWD\RUQHZVXUJLFDOSURFHGXUHVZDVREVHUYHG7KH RYHUDOOVWRQHIUHHUDWHZDVQRWVLJQLᚏFDQWGLᚎHUHQWLQJURXS WKDQLQJURXS
Eur Urol Suppl 2010;9(2):201
598
DEFINING THE FACTORS INFLUENCING THE DECISION ON POST-URETEROSCOPIC STENTING: A MULTIVARIATE ANALYSIS
.HUHQ3D]*0DEMHHVK1-*UHHQVWHLQ$%HQ&KDLP-0DW]NLQ+6RIHU0 Tel-Aviv Sourasky Medical Center, Dept. of Urology, Tel-Aviv, Israel Introduction & Objectives: 7R LGHQWLI\ IDFWRUV LQᚐXHQFLQJ WKH GUDLQDJH RSWLRQ DIWHUXUHWHURVFRSLFSURFHGXUHV Material & Methods: 7KHVWXG\FRPSULVHVDFRQVHFXWLYHVHULHVRISDWLHQWV UHIHUUHG IRU UHWURJUDGH HQGRVFRSLF WUHDWPHQW RI VWRQH GLVHDVH ,QWHUQDO VWHQWV ZHUHOHIWSRVWRSHUDWLYHO\LQ SDWLHQWV VWHQWHGJURXS DQGHLWKHURYHUQLJKW XUHWHUDO FDWKHWHU RU QR GUDLQDJH ZHUH FKRVHQ LQ SDWLHQWV QRQVWHQWHG JURXS 'HPRJUDSKLFFOLQLFDODQGLQWUDRSHUDWLYHGDWDZHUHVWDWLVWLFDOO\DVVHVVHG Results: 8UHWHURVFRS\ 856 UHWURJUDGH QHSKURVFRS\ 51 DQG FRPELQHG 856 DQG 51V ZHUH SHUIRUPHG LQ DQG SDWLHQWV UHVSHFWLYHO\ %LODWHUDO SURFHGXUHV ZHUH SHUIRUPHG LQ SDWLHQWV 8QLYDULDWH DQDO\VLV GHPRQVWUDWHG WKDW VLJQLᚏFDQW SURJQRVWLFDWRUV IRU QRQVWHQWLQJ GHFLVLRQ DUH VWRQHVL]H PP S SUHYLRXVHQGRVFRSLFWUHDWPHQW 25S SUHRSHUDWLYHLQWHUQDOVWHQW 25S RSHUDWLYHWLPH PLQ S VXUJHRQH[SHULHQFH S EDVNHWVWRQHUHPRYDO 25S QRVWRQH 25S 6LJQLᚏFDQWSURJQRVWLFDWRUVIRUVWHQWLQJZHUHVWRQHVL]Hุ PP 25S SUHYLRXV6:/ 25S KROPLXPODVHUIUDJPHQWDWLRQ 25S DQGRSHUDWLYHWLPHุPLQ 25 S $JHJHQGHU RSHUDWLRQ W\SH VWRQH ORFDWLRQ DQG ELODWHUDOLVP GLG QRW VLJQLᚏFDQWO\ LQᚐXHQFH WKH GHFLVLRQIRUSRVWRSHUDWLYHVWHQWLQJ0XOWLYDULDWHDQDO\VLVGHPRQVWUDWHGWKDWSUHYLRXV WUHDWPHQWSUHRSHUDWLYHLQWHUQDOVWHQWRSHUDWLYHWLPHDQGVXUJHRQH[SHULHQFHDUH LQGHSHQGHQWSURJQRVWLFDWRUVRIWKHFKRLFHRISRVWRSHUDWLYHGUDLQDJH Conclusions: 7KH FKRLFH RI GUDLQDJH DIWHU UHWURJUDGH HQGRVFRSLF SURFHGXUHV LV LQGHSHQGHQWO\ LQᚐXHQFHG E\ SUHYLRXV WUHDWPHQW SUHRSHUDWLYH LQWHUQDO VWHQW RSHUDWLYHWLPHDQGVXUJHRQH[SHULHQFH7KHVHᚏQGLQJVPLJKWKHOSLQWKHGHFLVLRQ PDNLQJ SURFHVV DERXW WKH W\SH RI SRVWRSHUDWLYH GUDLQDJH KHOSLQJ LQ LPSURYLQJ WUHDWPHQWHᚑFLHQF\DQGLQGHFUHDVLQJVHFRQGDU\PRUELGLW\
599
URETEROSCOPY IN PREGNANT WOMEN WITH CLINICALLY ACUTE URETERAL OBSTRUCTION
8OYLN2+ºVWPDUN-*%DNNH$0*MHQJVWº37RUNHOVHQ7.8OYLN10 Haukeland University Hospital, Dept. of Urology, Bergen, Norway Introduction & Objectives: ,Q ZH LQWURGXFHG D SURJUDPPH IRU GLDJQRVLV REVHUYDWLRQ DQG WUHDWPHQW RI SUHJQDQW ZRPHQ ZLWK DFXWH ᚐDQN SDLQ LQGLFDWLQJ XUHWHUDO REVWUXFWLRQ ,I WKH SDLQ ZDV VHYHUH HQRXJK WR UHTXLUH RSLRLG PHGLFDWLRQ IRUPRUHWKDQGD\VXUHWHURVFRS\ZDVRᚎHUHGERWKIRUGLDJQRVLVDQGWUHDWPHQW RIWKHVXVSHFWHGREVWUXFWLRQ:HUHSRUWRXUH[SHULHQFHVZLWKXUHWHURVFRS\LQWKLV VLWXDWLRQ Material & Methods: 7KHGLDJQRVLVRIDFXWHXUHWHUDOREVWUXFWLRQZDVEDVHGRQ KLVWRU\DQGSK\VLFDOH[DPLQDWLRQEORRGDQDO\VLVXULQHDQDO\VLVDQG86H[DPLQDWLRQ RINLGQH\DQGEODGGHU;UD\H[DPLQDWLRQVZHUHDYRLGHG,IVHYHUHDFXWHᚐDQNSDLQ ZDVVHHQZLWKXSSHUXULQDU\WUDFWLQIHFWLRQRULPSDLUHGUHQDOIXQFWLRQXUHWHURVFRS\ ZDVSHUIRUPHGZLWKRXWGHOD\$WRWDORIXUHWHURVFRSLHVKDYHEHHQSHUIRUPHG GXULQJ SUHJQDQFLHVLQZRPHQZLWKVHPLULJLGLQVWUXPHQWVLQHLWKHUJHQHUDO UHJLRQDORUWRSLFDODQHVWKHVLDFRPELQHGZLWKOLJKWVHGDWLRQ Results: 8UHWHURVFRS\FRXOGEHSHUIRUPHGLQDOOFDVHVHYHQLQWKHWKLUGWULPHVWHU 8UHWHUDO VWRQHV ZHUH IRXQG LQ RI XUHWHURVFRSLHV SHUIRUPHG IRU VXVSHFWHG XUHWHUDOVWRQHVHGHPDLQWKHORZHUXUHWHUZLWKRXWDQ\VWRQHLQS\RQHSKURVLVLQ EORRGFORWVLQWKHUHQDOSHOYLVLQDQGPHJDORXUHWHULQ7ZRDGGLWLRQDOSDWLHQWV KDG 83- REVWUXFWLRQ GLDJQRVHG EHIRUH WKH SUHJQDQF\ 7KH HQGRVFRSLF ᚏQGLQJV
ZHUHQRUPDOLQFDVHVSDWLHQWVQHHGHGPRUHWKDQXUHWHURVFRS\GXULQJWKH VDPHSUHJQDQF\ 2QHSDWLHQWH[SHULHQFHGVWRQHREVWUXFWLRQRIWKHOHIWXUHWHUDQG VRPHZHHNVODWHURIWKHULJKWXUHWHU2QHSDWLHQWKDGXUHWHURVFRSLHVWRWUHDWERWK DQREVWUXFWLQJVWRQHDQGDFDOFLᚏHG--VWHQW2QHSDWLHQWZDVWUHDWHGDVHFRQG WLPHIRUDGLVORFDWHG--VWHQW2QHSDWLHQWKDGWZRXUHWHURVFRSLHVIRUXQH[SODLQHG ORQJVWDQGLQJXUHWHUDOREVWUXFWLRQZLWKXSSHUXULQDU\WUDFWLQIHFWLRQLQLWLDOO\GUDLQHG ZLWKDSHUFXWDQHRXVQHSKURVWRP\WXEHSDWLHQWVQHHGHGXUHWHURVFRS\IRUFOLQLFDOO\ VXVSHFWHGXUHWHUDOREVWUXFWLRQLQDQGGLᚎHUHQWSUHJQDQFLHVUHVSHFWLYHO\7KHUH ZHUH QRUPDO GHOLYHULHV FHVDUHDQ VHFWLRQV VHYHQ ZHHNV SUHPDWXUH GHOLYHU\HOHFWLYHWHUPLQDWLRQXQUHODWHGWRXUHWHURVFRS\DQGXQNQRZQ7KH SUHJQDQFLHVUHVXOWHGLQQRUPDOEDELHVLQFOXGLQJWZLQFRXSOHV,QDGGLWLRQ FKLOGZDVERUQZLWKFOHIWOLSSDODWHZLWKPLOGFHUHEUDOSDOV\DQGXQNQRZQ Conclusions: 8UHWHURVFRS\ZLWKVHPLULJLGLQVWUXPHQWVLVVDIHDQGHᚎHFWLYHDQG VKRXOGUHSODFHRWKHULQYDVLYHWUHDWPHQWPRGDOLWLHVLQPRVWSUHJQDQWZRPHQZLWK FOLQLFDOO\VXVSHFWHGVHYHUHXUHWHUDOREVWUXFWLRQ
600
COST ANALYSIS OF FLEXIBLE URETERORENOSCOPY AFTER 630 INTERVENTIONS
/LVNH32EHU3$JXLODU<=LPPHUPDQQV9/DKPH6 Siloah St. Trudpert Hospital, Dept. of Urology, Pforzheim, Germany Introduction & Objectives: )OH[LEOHXUHWHURUHQRVFRS\SOD\VDQLPSRUWDQWUROHLQ WKHWUHDWPHQWRIXSSHUXULQDU\WUDFWGLVHDVHV'XHWRWKHXVHDQGWHFKQLFDOZHDU RIᚐH[LEOHVFRSHVHYHU\SURFHGXUHFDXVHVDGGLWLRQDOFRVWV)UHTXHQF\DQGFRVWV RIUHSDLUZHUHDQDO\VHG Material & Methods: FRQVHFXWLYH ᚐH[LEOH XUHWHURUHQRVFRSLF SURFHGXUHV ZHUH HYDOXDWHG ,Q DOO FDVHV DQ XUHWHUDO DFFHVV VKHDWK ZDV XVHG ,Q FDVHV UHQDOSHOYLFRUFDO\FHDOVWRQHVZHUHWUHDWHG,QFDVHVKROPLXPODVHUOLWKRWU\SV\ wP ᚏEUH ZDV XVHG ,Q WRWDO WKH SURFHGXUHV ZHUH SHUIRUPHG E\ ᚐH[LEOH XUHWHURVFRSHV 9LSHU5LFKDUG:ROI&RPSDQ\.QLWWOLQJHQ*HUPDQ\ Results: ,Q WRWDO UHSDLUV ZHUH QHFHVVDU\ LQ LQVWUXPHQWV 7RWDO FRVWV RI UHSDLU ZHUH HXUR 7KH PHDQ FRVWV SHU SURFHGXUH ZHUH HXUR 7KHDYHUDJHGXUDELOLW\RIHDFKLQVWUXPHQWZDV SURFHGXUHV5HSDLURIᚐH[LEOH VFRSHV ZDV QHFHVVDU\ GXH WR DOWHUDWLRQ RI WKH ZRUNLQJ FKDQQHO WKH ZLUHV IRU GHᚐHFWLRQDOWHUDWLRQRIWKHVFRSHvVVXUIDFHDQGEUHDNRIRSWLFDOᚏEUHV'DPDJHV ZHUHFDXVHGE\XVHRIKROPLXPODVHUGXULQJRSHUDWLRQVWHULOLVDWLRQSURFHVVDQG WUDQVSRUWDWLRQ Conclusions: )OH[LEOH XUHWHURUHQRVFRS\ LV DVVRFLDWHG ZLWK DGGLWLRQDO FRVWV GXH WR WKH IUDJLOLW\ RI LQVWUXPHQWV 7KHVH FRVWV RI UHSDLU DUH DFFHSWDEOH DV WKH\ RQO\ DFFRXQWIRUDPLQRUSDUWRIWKHUHLPEXUVHPHQW%HFDXVHRIWKHVKRUWHUWUHDWPHQW WLPHORZHUUHWUHDWPHQWUDWHDQGKLJKHUVWRQHIUHHUDWHWKDQVKRFNZDYHOLWKRWULSV\ LW LV FRVWHᚎHFWLYH WR XVH ᚐH[LEOH XUHWHURUHQRVFRS\ LQ HQGRXURORJLFDO VWRQH WUHDWPHQW
601
EFFICIENCY AND MORBIDITY OF FLEXIBLE URETERONEPHROSCOPY IN OBESE PATIENTS
'HORUPH*1JX\HQ+XX<*XLOODXPH*&KDEDQQHV(%HUQDUGLQL6 /RRFN3<%LWWDUG+.OHLQFODXVV. University Hospital Saint-Jacques, University of Franche-Comté, Dept. of Urology and Renal Transplantation, Besançon, France Introduction & Objectives: 0DQ\UHWULHYDOPHWKRGVIRUXULQDU\VWRQHVVXFKDV H[WUDFRUSRUHDO VKRFN ZDYH OLWKRWULSV\ (6:/ RU SHUFXWDQHRXV QHSKUROLWKRWRP\ DUHDVVRFLDWHGZLWKSRRUUHVXOWVDQGLQFUHDVHGPRUELGLW\LQREHVHSDWLHQWVZLWKD ERG\PDVVLQGH[ %0, VXSHULRUWRNJP7KHDLPRIWKHVWXG\ZDVWRDQDO\]H UHVXOWV DQG PRUELGLW\ RI ᚐH[LEOH XUHWHURQHSKURVFRS\ LQ REHVH SDWLHQWV DQG WR FRPSDUHZLWKUHVXOWVREWDLQHGLQQRQREHVHSDWLHQWV Material & Methods: :H FRQGXFWHG D UHWURVSHFWLYH VWXG\ LQFOXGLQJ DOO ᚐH[LEOH XUHWHURQHSKURVFRS\ SURFHGXUHV SHUIRUPHG IRU VWRQHV UHWULHYDO LQ RXU LQVWLWXWLRQ EHWZHHQ-DQXDU\DQG'HFHPEHU'XULQJWKHVWXG\SHULRGᚐH[LEOH XUHWHURQHSKURVFRS\ ZHUH SHUIRUPHG IRU VWRQHV UHWULHYDO FRQFHUQHG REHVH SDWLHQWV ZLWK %0,! NJP FRQFHUQHG QRQ REHVH SDWLHQWV DQG IRU SURFHGXUHVGDWDUHJDUGLQJ%0,ZHUHQRWDYDLODEOH'DWDFRQFHUQLQJSDWLHQWV $JH %0, SUHYLRXV WUHDWPHQW VWRQH QDWXUH ORFDWLRQ QXPEHU SURFHGXUH RSHUDWLQJ WLPHPRUELGLW\UHVXOWV ZHUHH[WUDFWHGIURPSDWLHQWFKDUWVLQFOXGHGLQDGDWDEDVH DQGDQDO\]HG)ROORZXSZDVSHUIRUPHGDWDQGPRQWKV6XFFHVVZDVGHᚏQHG E\FOHDULPDJLQJ FRPSOHWHVWRQHIUHH DWUHQDOWRPRJUDSK\DQGXOWUDVRQRJUDSK\ Results: 0HDQ%0,ZDVNJPLQJURXS 2EHVHSDWLHQWV DQGNJ PLQJURXS 1RQREHVHSDWLHQWV $SUHYLRXVWUHDWPHQWIRUVWRQHIUDJPHQWDWLRQ RUUHWULHYDOZDVSHUIRUPHGDQGUHVXOWHGLQUHVLGXDOIUDJPHQWVLQLQJURXS DQGLQJURXS S $SUHYLRXV(6:/ZDVDIDLOXUHLQDQGLQ JURXSDQGUHVSHFWLYHO\0HDQVWRQHVL]H PPLQJURXSYV PPLQJURXSS 16 VWRQHORFDWLRQ ORZHUSROHLQJURXSYVLQ JURXSS 16 DQGVWRQHQDWXUHZDVQRWGLᚎHUHQWLQERWKJURXSV2SHUDWLQJWLPH ZDVVLPLODULQJURXSDQGJURXS PLQYVPLQS 16 7KH UDWHRIPLQRUFRPSOLFDWLRQV IHYHUKHPDWXULDᚐDQFNSDLQ ZDVQRWKLJKHULQREHVH SDWLHQWV WKDQ LQ QRQ REHVH SDWLHQWV 1R PDMRU FRPSOLFDWLRQV UHTXLULQJSURORQJHGKRVSLWDOVWD\RUQHZVXUJLFDOSURFHGXUHVZDVREVHUYHG7KH RYHUDOOVWRQHIUHHUDWHZDVQRWVLJQLᚏFDQWGLᚎHUHQWLQJURXS WKDQLQJURXS
Eur Urol Suppl 2010;9(2):201