title: Managing female urinary incontinence: a regional prospective analysis of cost-utility ratios (curs) and effectiveness.
abstract: BACKGROUND
  To evaluate the cost-utility of incontinence treatments, particularly anticholinergic therapy, by examining costs and quality-adjusted life years.
  
  
  METHODS
  A prospective cohort study of women who were consecutively referred by general practitioners (GPs) to the Urology Department because of urinary incontinence. The primary outcome was evaluation of the cost-utility of incontinence treatments (surgery, medical therapy and physiotherapy) for stress and/or urgency incontinence by examining costs and quality-adjusted life years.
  
  
  RESULTS
  137 consecutive female patients (mean age 60.6 ± 11.6; range 36-81) were enrolled and stratified according to pathologies: SUI and UUI. Group A: SUI grade II-III: 43 patients who underwent mid-urethral sling (MUS); Group B: SUI grade I-II 57 patients who underwent pelvic floor muscle exercise and Group C: UUI: 37 patients who underwent antimuscarinic treatment with 5 mg solifenacin daily. The cost utility ratio (CUR) was estimated as saving more than €1200 per QALY for surgery and physiotherapy and as costing under € 100 per QALY for drug therapy.
  
  
  CONCLUSIONS
  This study shows that appropriate diagnosis and treatment of a patient with incontinence lowers National Health Service costs and improves the benefits of treatment and quality of life.
authors.affiliation: Department of Medical-Surgical Specialties and Public Health, Urology and Andrology Section, University of Perugia, Perugia. azucchi@unipg.it.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Costantini
authors.forename: Massimo
authors.initials: M
authors.lastname: Lazzeri
authors.forename: Vittorio
authors.initials: V
authors.lastname: Bini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Zucchi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Scarponi
authors.forename: Massimo
authors.initials: M
authors.lastname: Porena
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D014549:Urinary Incontinence / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*