Objective: To investigate the cost-effectiveness of urethral bulking polydimethylsiloxane-Urolastic® (PDMS-U) compared with mid-urethral sling (MUS) surgery for stress urinary incontinence (SUI) at 1-year follow-up.
Design: Prospective, two-arm cohort study with 2-year follow-up.
Setting: International multicentre.
Population: Women with moderate to severe SUI.
Main Outcome Measures: Primary outcome was subjective cure (Patient Global Impression of Improvement).
Secondary Outcomes: objective cure (negative cough stress test), Urogenital Distress Inventory (UDI-6), complications and re-interventions. Cost-effectiveness outcomes: total costs, quality-adjusted life year (QALY) using IIQ7-scores (Incontinence Impact Questionnaire) and EQ-5D-5L, incremental cost-effectiveness ratio (ICER) and monetary benefit (adjusted for baseline confounders).
Results: In all, 131 PDMS-U and 153 MUS surgery patients were treated. Subjective cure rates for MUS surgery and PDMS-U were, respectively: 101/112 (90%) versus 40/87 (46%), adjusted odds ratio (aOR; for age, body mass index [BMI], severity, type of urinary incontinence and previous SUI procedure) was 4.9. Objective cure rates for MUS surgery and PDMS-U were respectively: 98/109 (90%) versus 58/92 (63%), aOR 5.4. Average total costs for PDMS-U and MUS surgery were €3567 and €6688. ICER for MUS surgery cost €15 598 per IIQ QALY and €37 408 per EQ-5D-5L QALY. With a willingness to pay (WTP) of €25 000, MUS has a 84% chance of being cost-effective using IIQ, whereas PDMS-U has a 99% chance of being cost-effective using EQ-5D-5L.
Conclusion: MUS surgery is more cost-effective in realising improved disease-specific quality of life (QoL), while PDMS-U is more cost-effective in realising improved generic QoL.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/1471-0528.17396 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predictive Factors for Poor Outcome after Laparoscopic and Open Colposuspension: A Comparative Analysis Using the BSUG Database.
Int Urogynecol J
January 2025
Department of Urogynaecology, Birmingham Women's and Children NHS Foundation Trust, Birmingham, UK.
Introduction: Colposuspension has been a well-accepted surgical treatment for stress urinary incontinence (SUI) since 1961. However, there is limited research on predictors of poor outcomes in both laparoscopic colposuspension (LC) and open colposuspension (OC) procedures. This study aimed to identify predictors linked to patient-reported failure after colposuspension.
View Article and Find Full Text PDFRobotic Resection of an Ectopic Parathyroid Gland: A Systematic Review.
Cureus
December 2024
General Surgery, East Sussex Healthcare NHS Trust, Brighton and Hove, GBR.
Ectopic parathyroid glands result from abnormal migration during development. If not detected promptly, they can lead to persistent or recurrent primary hyperparathyroidism (pHPT). Inferior parathyroid glands are typically located in the anterior mediastinum, while superior parathyroid glands are often near the tracheoesophageal groove, both of which contribute to pHPT.
View Article and Find Full Text PDFEvolutionary study and structural basis of proton sensing by Mus GPR4 and Xenopus GPR4.
Cell
December 2024
Key Laboratory Experimental Teratology of the Ministry of Education, New Cornerstone Science Laboratory, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shandong University, Jinan, Shandong 250012, China; NHC Key Laboratory of Otorhinolaryngology, Qilu Hospital of Shandong University, Advanced Medical Research Institute, Shandong University, Jinan, China; Department of Physiology and Pathophysiology, State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China. Electronic address:
Animals have evolved pH-sensing membrane receptors, such as G-protein-coupled receptor 4 (GPR4), to monitor pH changes related to their physiology and generate adaptive reactions. However, the evolutionary trajectory and structural mechanism of proton sensing by GPR4 remain unresolved. Here, we observed a positive correlation between the optimal pH of GPR4 activity and the blood pH range across different species.
View Article and Find Full Text PDF10-Year outcomes of marginal ulcer formation and impact of gastrojejunostomy technique in Roux-en-Y gastric bypass.
Surg Obes Relat Dis
December 2024
Division for General/GI Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address:
Background: Marginal ulcers (MUs) are potential complications following Roux-en-Y gastric bypass (RYGB) surgery. Our institution performs 3 different laparoscopic gastrojejunal anastomosis (GJA) techniques. The aim of this study was to analyze the incidence of MUs between 25-mm circular stapler (CS), linear stapler (LS), and hand-sewn (HS) GJA techniques using data collected over a 10-year period.
View Article and Find Full Text PDFUnsupervised clustering analysis of treatment strategies for elite female athletes with severe stress urinary incontinence: focusing on competition return and SUI improvement.
Int Urol Nephrol
December 2024
Yokosuka Urogynecology and Urology Clinic, Ootaki 2-6, Yokosuka, Kanagawa, 238-0008, Japan.
Purpose: To evaluate two primary outcomes in elite female athletes (EFAs) with severe stress urinary incontinence (SUI) 24 months post-intervention: return to elite-level competition and improvement in SUI symptoms. Clustering analysis was conducted to identify subgroups within the patient population and explore treatment efficacy.
Methods: A retrospective analysis was performed on 183 EFAs with severe SUI who underwent treatments including pelvic floor muscle training (PFMT), vaginal and urethral erbium laser (Fotona Laser), and mid-urethral sling (MUS) surgery.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!