Introduction & Objectives
The aim of this study was to compare the loss of productivity between two minimally invasive techniques, extracorporeal lithotripsy (ESWL) vs holmium ureterorenoscopy-laser (URS) for the treatment of reno-ureteral litiasis, less than 2 cm.
Material & Methods
We have conducted a prospective study of 81 patients, which were treated during 2016 for reno-ureteral lithiasis less than 2 cm. Of these people, 37 (45.67%) were treated with ESWL (17 renal and 20 ureteral) and 44 (54.32%) with URS (20 renal and 24 ureteral). Additionally, 43.2% of each group were active (16 in ESWL and 19 in URS). The variables analysed were two, the days off work due to the treatment and the subsequent recovery and another the estimation of the indirect cost caused by the loss of labour productivity. To calculate these indirect costs, monthly gain of the Salary Structure Survey 2015 (INE) was considered regarding the actual days off work. In addition, the Development of the Work Productivity and Activity Impairment (WPAI) Questionnaire was also used to determine the degree of perception of lost productivity during work and during daily activities.
The mean of sessions was 2.02 for the ESWL group and 1.02 for the URS until resolution of the stone. The average number of days off work in the URS group was 7.16 days, while in the ESWL case was 3.18 (Student's T p = 0.034). The total indirect costs resulting from the lost productivity in the URS Group were 621.55 euros and 276.05 euros in the ESWL Group. The degree of affectation in the work perceived by patients submitted to URS was 18.88% and 21.33% in the ESWL Group. The degree of affectation to perform daily activities was 24.44% in URS and 15% in ESWL.
According to our results, the ESWL is shown as a technique that may require a greater number of sessions for the resolution of reno-ureteral lithiasis smaller than 2 cm, but with a lower loss of productivity from the patient.