Cost-analyzes based on a prospective, randomized study comparing laparoscopic colposuspension with a tension-free vaginal tape procedure

Abstract

Cost-analyzes based on a prospective, randomized study comparing laparoscopic colposuspension with a tension-free vaginal tape procedure.Persson, Jan; Teleman, Pia; Etén-Bergquist, Christina; Wölner-Hanssen, PålPublished in: Acta Obstetricia et Gynecologica Scandinavica DOI: 10.1034/j. 1600 -0412.2002 .811112.x Published: 2002 Link to publication Citation for published version (APA): Persson, J., Teleman, P., Etén-Bergquist, C., & Wölner-Hanssen, P. (2002). Cost-analyzes based on a prospective, randomized study comparing laparoscopic colposuspension with a tension-free vaginal tape procedure. Acta Obstetricia et Gynecologica Scandinavica, 81(11), 1066-1073. DOI: 10.1034/j.1600-0412.2002 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Background. The aim of this study was to compare laparoscopic colposuspension with tension-free vaginal tape (TVT) in terms of costs to the county. Methods. In a prospective, randomized study, we approached 270 consecutive women presenting for evaluation of stress urinary incontinence symptoms at one university hospital. Preoperatively, and at 1-year follow-up, the women underwent urodynamic evaluation, an ultra-short pad-test and completed a lower urinary tract symptoms questionnaire. We randomized 79 consenting, eligible women to either procedure; a 1-year follow-up examination was performed on 68/71 (96%) women that were available. The procedures were performed as described previously. Main outcome measures were all relevant costs for goods and services associated with the procedures. Results. The baseline characteristics of the two groups were similar. The TVT procedure was performed significantly faster than the laparoscopic colposuspension, i.e. 44.9 ∫ 14.2 min compared with 60.5 ∫ 13.4 min (p Ͻ 0.0001). Even so, procedural costs were significantly lower for laparoscopic colposuspension than for TVT (s 1273.4 compared with s 1342.8 p Ͻ 0.001). At the 1-year follow-up visit, three women operated on with TVT and one operated on with laparoscopic colposuspension required re-operation for continuous stress urinary incontinence. One women operated on with TVT had her sling cut for bladder-emptying problems. Total costs, including re-operations were s 1462.6 for a TVT procedure and s 1314.5 for a laparoscopic colposuspension. Conclusion. In our hands, the laparoscopic colposuspension was less expensive to the county than the TVT procedure.

Midurethral slings for treatment of stress urinary incontinence review

“…This remained the case in the longer term of up to 8 years where Paraiso et al reported TVT and laparoscopic Burch colposuspension continued to have similar rates of cure (RR, 1.18; 95% CI, 0.36‐3.81). One trial reported reoperation rates at 1 year, with three out of 38 women in the TVT group and one out of 32 woman in the laparoscopic colposuspension group undergoing repeat surgery for “noncure.” They reported no difference in the perioperative complication rates between laparoscopic colposuspension and vaginal sling procedures (RR, 0.99; 95% CI, 0.60‐1.64) but surgical outcome measures, specifically length of hospital stay and return to normal activities, favored the MUS group …”

Tension‐free vaginal tape and laparoscopic mesh colposuspension in the treatment of stress urinary incontinence: immediate outcome and complications − a randomized clinical trial

“…Persson et al compared the costs of the LC and TVT procedures. They used sutures instead of mesh in the laparoscopic procedure (15). They found that LC was less expensive than the TVT procedure.…”

Systematic review: Laparoscopic colposuspension and tension‐free vaginal tape: a systematic review*

“…A total of seven trials were identified from the search, all of which were randomised control trials involving laparoscopic colposuspension and TVT in each of the arms, so were included in this review. The characteristics of these seven trials are displayed in Table 2 11–17 . One study had published versions in both English and Italian languages 11 .…”