Cost Comparison of the Laparoscopic Burch Colposuspension,Laparoscopic Two-Team Sling Procedure,and the Transobturator Tape Procedure for the Treatment of Stress Urinary Incontinence |
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| Authors: | Katherine Lo Violaine Marcoux Stacey Grossman Rose Kung Patricia Lee |
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| Affiliation: | 1. Division of Urogynaecology, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto ON;2. Department of Obstetrics and Gynecology, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal QC;3. Department of Obstetrics and Gynaecology, York Central Hospital, Toronto ON;1. Department of Obstetrics and Gynaecology, University of Calgary, Calgary AB;2. Departments of Family Medicine, Community Health Sciences, and Surgery, University of Calgary, Calgary AB;1. Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON;2. Institute for Clinical Evaluative Sciences, Toronto ON;3. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto ON;4. Dalla Lana School of Public Health, University of Toronto, Toronto ON;5. Department of Gynecologic Oncology, Princess Margaret Hospital, Toronto ON;1. Department of Obstetrics and Gynaecology, Western University, London ON;2. Department of Pathology, University of Toronto, Toronto ON;1. Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Quebec City QC;2. Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec City QC;3. Department of Obstetrics and Gynecology, University of Montreal, Montreal QC;4. Department of Obstetrics and Gynecology, St-Mary’s Hospital, McGill University, Montreal QC |
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| Abstract: | ObjectiveTo 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.MethodsWe 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.ResultsThe 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).ConclusionA 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. |
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