Background and Objective: Urolithiasis is a growing burden on health-care systems. Extracorporeal shock wave lithotripsy (ESWL), retrograde intrarenal surgery (RIRS), and percutaneous nephrolithotomy (PCNL) are the main interventional options, yet their comparative cost-effectiveness is not fully established. We systematically reviewed full economic evaluations comparing these modalities.<\/p>\n
Methods: A systematic search of PubMed\/MEDLINE, Scopus, and Web of Science was performed for studies published between January 2010 and December 2025 in accordance with PRISMA guidelines (PROSPERO registration: CRD420261303193). Eligible studies included cost analyses, cost-minimization, cost-effectiveness, cost-utility, and cost-benefit analyses comparing ESWL, RIRS, and\/or PCNL. Data extraction and risk-of-bias assessment using the ECOBIAS checklist were independently conducted by two reviewers.<\/p>\n
Results: Of 1,861 records identified, 18 studies met inclusion criteria: ESWL vs RIRS (n=9), ESWL vs PCNL (n=2), RIRS vs PCNL (n=4), and three-way comparisons (n=3). Ten studies assessed cost-effectiveness, six cost-utility, and two cost analyses. Most studies were conducted in Europe (n=7), followed by the USA (n=3) and Asia (n=3).In ESWL vs RIRS comparisons, randomized trials reported ~\u00a3809 lower costs for ESWL at 6 months with small QALY losses (\u22120.018 to \u22120.021), whereas long-term claims data showed higher 7-year cumulative costs for ESWL (\u20ac3,240) compared with RIRS (\u20ac2,979). In ESWL vs PCNL studies, ESWL had lower per-patient costs (US$490\u2013650 vs US$1,120\u20131,138) despite higher initial stone-free rates with PCNL. In RIRS vs PCNL evaluations, UK trials reported mean 12-month costs of \u00a35,298 for RIRS and \u00a34,565 for PCNL, with PCNL showing an 87% probability of cost-effectiveness at \u00a320,000\/QALY. Retrospective cohorts reported similar cumulative costs due to repeated RIRS sessions. Studies showed substantial heterogeneity in time horizons (2 weeks\u20137 years), perspectives, and costing methods; only one-third performed probabilistic sensitivity analyses.<\/p>\n
Conclusions: Among stone treatment options, RIRS is more cost-effective than ESWL for smaller stones over longer time horizons, while ESWL dominates in the short term (<12 months). For larger stones, PCNL is generally the most cost-effective option. However, study heterogeneity and methodological limitations restrict the generalizability of these findings.<\/p>","protected":false},"excerpt":{"rendered":"
Background and Objective: Urolithiasis is a growing burden on health-care systems. Extracorporeal shock wave lithotripsy (ESWL), retrograde intrarenal surgery (RIRS), and percutaneous nephrolithotomy (PCNL) are the main interventional options, yet their comparative cost-effectiveness is not fully established. We systematically reviewed … read more<\/a><\/p>","protected":false},"author":3,"featured_media":187,"menu_order":0,"template":"","meta":{"_acf_changed":false},"portfolio-type":[18],"portfolio-tag":[],"class_list":["post-186","portfolio","type-portfolio","status-publish","has-post-thumbnail","hentry","portfolio-type-highlight-session-2"],"acf":[],"_links":{"self":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio\/186","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio"}],"about":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/types\/portfolio"}],"author":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/users\/3"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media\/187"}],"wp:attachment":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media?parent=186"}],"wp:term":[{"taxonomy":"portfolio-type","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-type?post=186"},{"taxonomy":"portfolio-tag","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-tag?post=186"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}