Evidence map›Paper›PMID 41830115›Full record

Trial reportBJU international2026

Cost-effectiveness of percutaneous nephrostomy vs JJ stent in obstructive urolithiasis: economic evaluation alongside the STent Or NEphrostomy (STONE) randomised controlled trial.

Hugo W Schuil, Nora Hendriks, Mohamed El Alili, Judith E Bosmans, Ruben G Duijnhoven, Bart C H Oskam, Tom J H Arends, Diederick Duijvesz, Alexander D Horsch, Bart van der Heij and 18 more

Abstract readRandomized Controlled TrialComparative StudyEquivalence Trial
In one paragraph

Trial report in BJU international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors.

Hugo W SchuilDepartment of Urology, Alrijne Ziekenhuis, Leiderdorp, the Netherlands.ORCID 0000-0003-3494-9268
Nora HendriksDepartment of Urology, Alrijne Ziekenhuis, Leiderdorp, the Netherlands.ORCID 0000-0002-4605-6283
Mohamed El AliliDepartment of Health Sciences, Vrije Universiteit Amsterdam, Faculty of Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Judith E BosmansDepartment of Health Sciences, Vrije Universiteit Amsterdam, Faculty of Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Ruben G DuijnhovenClinical trials unit Healthcare Evaluation and Research, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Bart C H OskamDepartment of Urology, Meander Medisch Centrum, Amersfoort, the Netherlands.
Tom J H ArendsDepartment of Urology, Meander Medisch Centrum, Amersfoort, the Netherlands.
Diederick DuijveszDepartment of Urology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands.
Alexander D HorschDepartment of Radiology, Alrijne Ziekenhuis, Leiderdorp, the Netherlands.
Bart van der HeijDepartment of Urology, Zuyderland Medisch Centrum, Heerlen, the Netherlands.
Irene TjiamDepartment of Urology, Haga Ziekenhuis, The Hague, the Netherlands.
Hans van OverhageDepartment of Radiology, Haga Ziekenhuis, The Hague, the Netherlands.
Armand B G N LamersDepartment of Radiology, Amsterdam UMC, Amsterdam, the Netherlands.
Otto M van DeldenDepartment of Radiology, Amsterdam UMC, Amsterdam, the Netherlands.
Wout ScheepensDepartment of Urology, Catharina Ziekenhuis, Eindhoven, the Netherlands.
Jamie M A DrossaertsDepartment of Urology, Catharina Ziekenhuis, Eindhoven, the Netherlands.
Frank C H d'AnconaDepartment of Urology, Radboud university medical center, Nijmegen, the Netherlands.
Steven BoeringDepartment of Urology, Radboud university medical center, Nijmegen, the Netherlands.
Janneke I M van UhmDepartment of Urology, Leiden University Medical Center, Leiden, the Netherlands.ORCID 0000-0002-0589-3229
Rutger W van der MeerDepartment of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
Herman J H van RoijenDepartment of Urology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands.
Martin de KiefteDepartment of Radiology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands.
Ad J M HendrixDepartment of Urology, Zaans Medisch Centrum, Zaandam, the Netherlands.
Saskia WeltingsDepartment of Urology, Zaans Medisch Centrum, Zaandam, the Netherlands.ORCID 0000-0002-6587-2251
Rob C M PelgerDepartment of Urology, Leiden University Medical Center, Leiden, the Netherlands.
Harrie P BeerlageDepartment of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Guido M KamphuisDepartment of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Barbara M A SchoutDepartment of Urology, Alrijne Ziekenhuis, Leiderdorp, the Netherlands.

Funding

Leading the Change
6 · The paper itself

Abstract

objectiveTo evaluate whether percutaneous nephrostomy (PCN) is cost-effective compared to JJ ureteric stent in the acute treatment of obstructive urolithiasis. PATIENTS AND

methodsA randomised controlled non-inferiority trial with 204 patients with obstructive urolithiasis requiring decompression. Participants were randomly assigned to either PCN or JJ stent, with follow-up until the stone was surgically removed or passed spontaneously. Effectiveness outcomes included time to recovery and quality-adjusted life years (QALYs). Costs were assessed from a societal perspective, incorporating healthcare, patient-related, and lost productivity costs.

resultsWeighted mean procedure costs were €685 for PCN and €792 for JJ. Mean total societal costs were €8468 for PCN and €7122 for JJ. Largest cost differences were in productivity loss and home care. Time to recovery and QALYs were similar between groups. The probability that JJ was cost-effective compared to PCN was 0.74 for quicker recovery time and 0.74 for QALYs at a willingness-to-pay threshold of €0. Some cost and quality-of-life data were self-reported, and the analysis reflects the Dutch healthcare system, which may limit generalisability.

conclusionThe JJ ureteric stent was found to be the likely cost-effective option compared to PCN, despite higher procedural costs. Procedural costs can be lowered by performing procedures outside of an operating theatre. Most societal costs were made during the waiting period for definitive stone removal; future research should investigate whether total cost can be lowered by reducing waiting times.

Indexed as

Nephrostomy, PercutaneousStentsUreteral ObstructionUrolithiasisAdultAgedCost-Benefit AnalysisCost-Effectiveness AnalysisFemaleHumansMaleMiddle AgedQuality-Adjusted Life YearsTreatment OutcomeCost‐effectivenessJJ ureteric stentpercutaneous nephrostomyrandomised controlled trialurolithiasis

Identifiers

PMID41830115
PMCPMC13071540

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.