Cost analysis of laparoscopic versus open orchiopexy in the management of unilateral nonpalpable testicles

The Journal of Urology
Armando J LorenzoYair Lotan

Abstract

Laparoscopic exploration for the nonpalpable testicle (NPT) has been criticized for increased costs compared with primary inguinal/scrotal exploration, mostly due to high equipment costs and the need for open inguinal/scrotal exploration in many cases. We assessed costs associated with diagnostic laparoscopy vs inguinal/scrotal exploration followed by selective open or laparoscopic treatment for unilateral NPT to identify the most important factors that influence cost. A comprehensive literature review determined the probabilities of intra-abdominal or inguinal nubbins, blind-ending vas/vessels and intra-abdominal or inguinal gonads in patients with unilateral NPT. The costs of anesthesia, equipment and operating room use were obtained from our institution or derived from the literature. A model was created using computer software to compare the costs of initial scrotal/inguinal approach or initial laparoscopic exploration in a theoretical population of boys with unilateral NPT. We established a set of assumptions and generated a series of 1-way sensitivity analyses to detect cost influencing parameters. Based on the probabilities of intraoperative anatomical gonadal findings, use of reusable laparoscopic equipment and encompas...Continue Reading

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Citations

Jul 21, 2004·Journal of Endourology
May 17, 2007·Current Opinion in Pediatrics·John M Gatti, Daniel J Ostlie
Dec 3, 2014·The Urologic Clinics of North America·Ronnie G Fine, Israel Franco
Apr 4, 2006·The Surgical Clinics of North America·Jeffrey H Haynes
Apr 4, 2015·Journal of Pediatric Surgery·Arnaud Fotso KamdemMarie-Christine Woronoff-Lemsi
Mar 14, 2013·Journal of Pediatric Surgery·Nobufumi UedaYukichi Tanaka
Jul 4, 2013·Medical Decision Making : an International Journal of the Society for Medical Decision Making·M Elske van den Akker-van MarleUNKNOWN NST Expert Group
Feb 16, 2006·AORN Journal·Krista BraggNathaniel Cook
Apr 25, 2017·The Journal of Urology·Courtney L Shepard, Kate H Kraft
Jun 27, 2019·Journal of the Endocrine Society·Dimitrios T PapadimitriouGeorge Mastorakos

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