Balancing the utility of new technology against cost in urinary stone disease
Commentary

Balancing the utility of new technology against cost in urinary stone disease

Thomas Chi, Eric Taylor, Marshall L. Stoller

Department of Urology, University of California, San Francisco, California, USA

Correspondence to: Thomas Chi. Assistant Professor, Department of Urology, University of California, 400 Parnassus Ave, 6th Floor Urology Clinics, Box 0638, San Francisco, CA 94143, USA. Email: tchi@urology.ucsf.edu; Marshall L. Stoller, M.D. Professor and Vice Chair, Department of Urology, University of California, 400 Parnassus Ave, 6th Floor Urology Clinics, Box 0638, San Francisco, CA 94143, USA. Email: MStoller@urology.ucsf.edu.

Submitted Jul 09, 2014. Accepted for publication Aug 01, 2014.

doi: 10.3978/j.issn.2223-4683.2014.08.10


Several advances in endourologic technology have allowed for a greater scope of care to be provided to urologic patients via a minimally invasive approach. The greatest of these is likely the current generation of flexible ureteroscopes which allow for a level of maneuverability, with or without active secondary deflection, that rarely prevent lower pole renal access via a retrograde approach. Other technical advances such as the development of ureteral access sheaths, hydrophilic working wires, laser fibers, and various basket and biopsy devices have also helped to advance our endourologic capabilities in treating complex upper tract calculus or oncologic disease. Most of these tools have been widely adopted, but advanced imaging capabilities such as narrow-band imaging (NBI) and photodynamic diagnosis (PDD) have yet to gain wide acceptance and utilization (1). One of the primary barriers to adoption of any of these technologies, including the flexible ureteroscope, is the cost associated with both acquisition and maintenance of these devices. The greatest benefit of these advanced technologies will come when their high cost declines allowing for more global access to these tools.


Acknowledgements

None.


Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.


References

  1. Wetherell DR, Ling D, Ow D, et al. Advances in ureteroscopy. Transl Androl Urol 2014;3:321-7.
Cite this article as: Chi T, Taylor E, Stoller ML. Balancing the utility of new technology against cost in urinary stone disease. Transl Androl Urol 2014;3(3):328. doi: 10.3978/j.issn.2223-4683.2014.08.10