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Intraoperative cone-beam computed tomography (CBCT) can detect and guide removal of RFs to improve stone-free rates and potentially reduce SREs. This study compares total inhospital costs of standard PCNL versus CBCT-PCNL across an 18-month follow-up to evaluate whether higher upfront procedural costs are offset by reduced downstream care.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/stone-disease-cost-comparison-of-percutaneous-nephrolithotomy-with-and-without-intraoperative-cone-beam-computed-tomography-18-month-postoperative-analysis/453997/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/stone-disease-cost-comparison-of-percutaneous-nephrolithotomy-with-and-without-intraoperative-cone-beam-computed-tomography-18-month-postoperative-analysis/453997.png","ImageObject",300,407,{"name":92,"@type":93},"\tJames","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is intraoperative CBCT considered after percutaneous nephrolithotomy?","Question",{"text":112,"@type":113},"CBCT can better detect residual fragments and enable targeted removal during the same procedure, which may improve stone-free rates and reduce stone-related events.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were costs calculated in the 18-month comparison?",{"text":117,"@type":113},"Procedural costs were estimated using operative duration multiplied by a Dutch reference price per minute plus disposable costs. Follow-up costs included complications, SREs (e.g., reinterventions and ED visits), imaging, and consultations over 18 months.",{"name":119,"@type":110,"acceptedAnswer":120},"What was the overall cost difference between CBCT-PCNL and standard PCNL?",{"text":121,"@type":113},"Mean total costs per patient were €8725 for the CBCT group and €8564 for the control group, a difference of €167, with higher procedural costs largely offset by lower follow-up, complication, and SRE costs.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},453997,1791413579,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46,"preview_page_count":4},2336474466412,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","EUROPEAN U ROLOGY OPEN SCIENC E 8 3 ( 2 0 26 ) 1 25 – 13 2  \navailable [at www.sciencedirect.com](at www.sciencedirect.com)  \njournal [homepage: www.eu-openscience.europeanurology. com](homepage: www.eu-openscience.europeanurology. com)  \n| Stone Disease\u003Cbr>Cost Comparison of Percutaneous Nephrolithotomy With and Without Intraoperative Cone-beam Computed Tomography:\u003Cbr>18-month Postoperative Analysis\u003Cbr>Rosanne van Eea,, Chris A. Suijkera,,*, Antoinette D.I. van Asseltb,c, Inge M. van Oort a, Riemer A. Kingmaa, Stijn Roemelinga\u003Cbr>a Department of Urology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; b Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; c Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands |  |\n| --- | --- |\n| Article info | Abstract\u003Cbr>Background and objective: Residual fragments (RFs) after percutaneous nephrolithotomy (PCNL) increase the risk of stone-related events (SREs) such as reinterventions and emergency department (ED) visits. Intraoperative cone-beam computed tomography (CBCT) facilitates detection and removal of RFs to improve stone-free rates and potentially reduce SREs. To determine whether the initial increase in surgical costs for CBCT in a hybrid operating room (OR) is offset by a reduction in overall expenses by minimizing SREs, we compared the total inhospital health care costs of standard PCNL versus CBCT-PCNL over an 18-mo period.\u003Cbr>Methods: Data from a previous randomized controlled trial including 80 patients undergoing CBCT-PCNL and 80 undergoing conventional PCNL were analyzed. Procedural costs were calculated by multiplying operative duration by the Dutch reference price per minute, and adding disposable costs. Follow-up costs included costs for complications, SREs (reinterventions, ED visits, drainage, admissions), imaging, and consultations during 18 mo.\u003Cbr>Key findings and limitations: Assuming utilization rates of 42% for a hybrid OR and 92% for a conventional OR and following reference prices, we calculated mean total costs per patient of €8725 for the CBCT group and €8564 for the control group, with a difference of € 167. The 40.2% higher procedural costs for hybrid-OR PCNL were nearly offset by 38.3% lower follow-up, complication, and SRE costs. Limitations include the single-center design, incomplete cost standardization, and the exclusion of non-hospital costs such as productivity loss.\u003Cbr>Conclusions and clinical implications: While PCNL with CBCT in a hybrid OR increases operative costs, it lowers SREs and unplanned care expenses. Even at a significantly\u003Cbr> These authors contributed equally to this work and share first authorship.\u003Cbr>*\u003Cbr>Corresponding author. Department of Urology, University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. Tel. +31 50 3612380 .\u003Cbr>E-mail address: [c.a.suijker@umcg.nl](c.a.suijker@umcg.nl) (C.A. Suijker).  |\n| Article history:\u003Cbr>Accepted December 5, 2025\u003Cbr>Associate Editor:\u003Cbr>Silvia Proietti |  |\n| Keywords:\u003Cbr>Percutaneous nephrolithotomy Intraoperative cone-beam computed tomography\u003Cbr>Cost comparison\u003Cbr>Stone-related events Randomized controlled trial Urolithiasis\u003Cbr>Residual fragments |  |\n|  |  |\n\n[https://doi.org/10.1016/j.euros.2025.12.002](https://doi.org/10.1016/j.euros.2025.12.002)  \n2666-1683/􀀁 2025 The Author(s). Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY license ([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/)).  \nlower hybrid OR utilization rate, total health care costs remain comparable, so PCNL-CBCT can facilitate predictable resource use and efficient care, with potential benefits for patients and health care systems.  \nPatient summary: A new technique using CT (computed tomography) scans during surgery ","cbCailFZVDsRkCvE","https://ap.wps.com/l/cbCailFZVDsRkCvE","pdf",748799,"English","# Abstract\n## Background and objective\n## Methods\n## Key findings and limitations\n## Conclusions and clinical implications\n# Patient summary\n# Introduction\n## Achieving stone-free status in PCNL\n## Role of CBCT and prior evidence\n## Cost considerations and adoption barriers","[{\"question\":\"Why is intraoperative CBCT considered after percutaneous nephrolithotomy?\",\"answer\":\"CBCT can better detect residual fragments and enable targeted removal during the same procedure, which may improve stone-free rates and reduce stone-related events.\"},{\"question\":\"How were costs calculated in the 18-month comparison?\",\"answer\":\"Procedural costs were estimated using operative duration multiplied by a Dutch reference price per minute plus disposable costs. Follow-up costs included complications, SREs (e.g., reinterventions and ED visits), imaging, and consultations over 18 months.\"},{\"question\":\"What was the overall cost difference between CBCT-PCNL and standard PCNL?\",\"answer\":\"Mean total costs per patient were €8725 for the CBCT group and €8564 for the control group, a difference of €167, with higher procedural costs largely offset by lower follow-up, complication, and SRE costs.\"}]","Stone Disease - Cost Comparison of Percutaneous Nephrolithotomy With and Without Intraoperative Cone-beam Computed Tomography: 18-month Postoperative Analysis | PDF",1790739983]