title: Cost comparison of the laparoscopic burch colposuspension, laparoscopic two-team sling procedure, and the transobturator tape procedure for the treatment of stress urinary incontinence.
abstract: OBJECTIVE
  To compare medical costs of three surgical procedures for the treatment of primary stress urinary incontinence: the laparoscopic Burch colposuspension procedure, the laparoscopic two-team sling procedure, and the transobturator tape (TOT) procedure.
  
  
  METHODS
  We performed a retrospective observational study of isolated minimally invasive surgical procedures (no concomitant surgery) in 18 women with primary stress incontinence. Six women underwent a laparoscopic Burch colposuspension procedure, six underwent a laparoscopic two-team sling, and six underwent a TOT procedure. The main outcome measure was the mean aggregated medical cost per patient treated. Itemized calculations were made for (1) equipment costs; (2) surgeon, surgical assistant, and anaesthesiologist reimbursements; (3) nursing costs; (4) operating and recovery room costs; and (5) costs of stay in hospital.
  
  
  RESULTS
  The mean cost per patient undergoing a TOT procedure was $2547 (95% CI $2260 to $2833); for a laparoscopic Burch colposuspension it was $4354 (95% CI $3465 to $5244); and for a laparoscopic two-team sling procedure it was $5393 (95% CI $4959 to $5826). Significant differences were found across procedures using a one-way ANOVA. A TOT was lower in cost than both a Burch procedure, with a mean cost difference of $1807.88 (P < 0.001), and a sling procedure, with a mean cost difference of $2834.73 (P < 0.001).
  
  
  CONCLUSIONS
  A transobturator tape procedure has less direct medical costs than a laparoscopic Burch colposuspension or a laparoscopic two-team sling procedure in the surgical treatment of stress urinary incontinence.
authors.affiliation: Division of Urogynaecology, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto ON.
authors.forename: Katherine
authors.initials: K
authors.lastname: Lo
authors.affiliation: Department of Obstetrics and Gynecology, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal QC.
authors.forename: Violaine
authors.initials: V
authors.lastname: Marcoux
authors.affiliation: Department of Obstetrics and Gynaecology, York Central Hospital, Toronto ON.
authors.forename: Stacey
authors.initials: S
authors.lastname: Grossman
authors.affiliation: Division of Urogynaecology, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto ON.
authors.forename: Rose
authors.initials: R
authors.lastname: Kung
authors.affiliation: Division of Urogynaecology, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto ON.
authors.forename: Patricia
authors.initials: P
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D017048:Health Care Costs; D006801:Humans; D010535:Laparoscopy / Q000191:economics; D008875:Middle Aged; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000191:economics*; D014550:Urinary Incontinence, Stress / Q000601:surgery*