Comparison of health care costs for open Burch colposuspension, laparoscopic colposuspension and tension-free vaginal tape in the treatment of female urinary incontinence.
OBJECTIVE
To compare direct health care costs of treatment for stress urinary incontinence in Sweden with four different procedures: (i) open Burch colposuspension (OBC); (ii) laparoscopic colposuspension with sutures (LCS); (iii) laparoscopic colposuspension with mesh and staples (LCM), and (iv) Tension-free Vaginal Tape (TVT).


METHODS
A model was constructed representing a hospital with standardized surgical equipment, staff and average unit costs in 2003 Euros. The time used for anesthesia and surgery was calculated. Clinical data was collected from three different sources, a multicenter, randomized, prospective study comparing OBC with LCM with 1 year follow-up, a three-armed, prospective study where women were randomized to either OBC, LCM, or LCS with 1 year follow-up and a descriptive study reporting results of TVT with 5 year follow-up. Data collected from the studies and hospital cost data were put into the model to create the different cost elements.


RESULTS
The total cost per individual, showed a lower cost for TVT compared to the other alternatives. The direct costs for a TVT, euro1,366 were only 56% of the costs for an OBC, euro2,431 (P < 0.001) and 59% of the costs for a LCS, euro2,310 (P < 0.001).


CONCLUSIONS
When using a model and comparing health care costs for surgical treatment of female stress urinary incontinence in Sweden, the TVT procedure generated a lower direct cost than both open and laparoscopic colposuspension.
Ankardal
Maud
M
Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg Sweden. maud.ankardal@obgyn.gu.se
Järbrink
Krister
K
Milsom
Ian
I
Heiwall
Bengt
B
Lausten-Thomsen
Niels
N
Ellström-Engh
Marie
M
D002986:Clinical Trials as Topic; D003127:Colposcopy / Q000191:economics*; D017281:Cost of Illness; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000191:economics* / Q000379:methods; D011184:Postoperative Period; D053825:Suburethral Slings / Q000191:economics*; D013548:Sweden; D014550:Urinary Incontinence, Stress / Q000191:economics / Q000601:surgery / Q000628:therapy*; D013519:Urogenital Surgical Procedures / Q000191:economics* / Q000379:methods