[Outpatient female stress urinary incontinence surgery: budget impact study].
OBJECTIVE
The surgical procedures for the insertion of tension free vaginal tapes in the treatment of female stress urinary incontinence (SUI) are simple and can be done as outpatient operations. The aim of this study was to perform a budget study comparing TVT in an outpatient basis with transobturator tape (TOT) with hospital admission.


METHODS
Retrospective analysis of the medical records of 23 patients undergoing surgery for SUI between October 2004 and October 2005. 13 patients were treated by TVT in an outpatient basis (group 1, Department of Urology), 10 patients were treated by TOT with hospital admission (Group 2, Department of Gynaecology). Cost analysis was carried out by the construction of a Marcov model, incorporating the time sequence of the treatment, including adverse events and results. Variables considered for the analysis: number of visits, preoperative tests, operative time, tape cost, hospital stay, unpredicted visits in the first postoperative month at the outpatient clinics or emergency room, and hospital readmissions. Statistical analysis was performed with the G-Stat software. Student's t test was used to compare quantitative variables.


RESULTS
11/13 patients (84.6%) in group 1 completed the day-surgery protocol. Mean surgical time was 61.7 min. (SD 16.2; 35-100) and 61.6 min. (SD 8.3; 50-73) for groups I and 2 respectively. Two cases in group 1 had perioperative complications (15.4%); no patient in group 2 had perioperative complications. Mean hospital stay was 1.3 days for group 1 (SD 0.85; 1-4) and 2.9 days for group 2 (SD 0.31; 2-3). Three patients in group 1 (23%) and 2 in group 2 (20%) presented postoperative complications. Mean cost per process was 4740 EUR for group 1 and 7099 EUR for group 2.


CONCLUSIONS
SUI correction by tension free tapes as day surgery is a valid option which saves a substantial amount of resources.
Castillón Vela
Ignacio T
IT
Servicio de Urología, Hospital de Fuenlabrada, Fuenlabrada, Madrid, España. ignacio.castillon@telefonica.net
Redondo González
Enrique
E
Linares Quevedo
Ana Isabel
AI
Vallejo Herrador
Jorge
J
Ríos González
Emilio
E
Sáenz Medina
Javier
J
Páez Borda
Alvaro
A
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000009:adverse effects / Q000191:economics*; D014550:Urinary Incontinence, Stress / Q000191:economics* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000191:economics