Percutaneous Nephrostolithotomy-Is it Time to Abandon Extracorporeal Shock Wave Lithotripsy?

摘要

This issue of The Journal features 2 reports on the current status of percutaneous nephrostolithotomy (PCNL). Bagrodia et al (page 149) demonstrated that simultaneous bilateral PCNL saves an average of Dollars 4,374 to Dollars 5,126 in direct hospital costs compared to staged bilateral PCNL with comparable complication rates. Unfortunately there are financial disincentives for urologists performing simultaneous bilateral PCNL in that they receive Dollars 275 to Dollars 1,069 less in reimbursement compared to staged PCNL. In this important article the authors argue that the urologist who performs simultaneous bilateral PCNL and, thereby, decreases costs to third party payers should appropriately and in turn receive increased reimbursement from said payers