Cost utility analysis of urethral bulking agents versus midurethral sling in stress urinary incontinence

Female Pelvic Medicine & Reconstructive Surgery
Cynelle M KunkleErika F Werner

Abstract

The aim of this study was to determine the cost utility of urethral bulking agents (BA) compared with midurethral slings (MUS) in the treatment of stress urinary incontinence (SUI) in patients without urethral hypermobility. A decision tree was constructed to compare the cost utility of urethral BA versus MUS in the setting of SUI without urethral hypermobility. Probability estimates for success, failure, and complications were obtained from the published literature. Immediate-term, short-term, and longer-term complications were accounted for over a 1-year time horizon in the model. One-way and 2-way sensitivity analyses and Monte Carlo simulations were performed to assess the robustness of our results. Our model demonstrated that MUS cost $436,465 more than BA for every 100 women treated in 1 year. Using MUS compared with BA leads to an incremental cost-effectiveness ratio of $70,400 per utility gained. Assuming a willingness to pay of $50,000, this makes MUS not cost-effective as a first-line treatment in many situations. When MUS costs less than $5132, it becomes a cost-effective first-line treatment, and when it costs less than $2035, it is cost saving. Bulking agents are more cost-effective than MUS over a 1-year time hori...Continue Reading

References

Apr 1, 1991·Journal of the American Geriatrics Society·S Hunskaar, A Vinsnes
Sep 1, 2001·Obstetrics and Gynecology·L WilsonL L Subak
Nov 8, 2002·Acta Obstetricia Et Gynecologica Scandinavica·Jan PerssonPål Wølner-Hanssen
Sep 21, 2004·International Urogynecology Journal and Pelvic Floor Dysfunction·F BanoR Dyer
Jun 1, 2005·BJOG : an International Journal of Obstetrics and Gynaecology·Christopher F MaherPhilip Schluter
Oct 26, 2005·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·S W BaiS K Kim
Apr 4, 2006·Obstetrics and Gynecology·Leslee L SubakUNKNOWN Diagnostic Aspects of Incontinence Study Group
May 19, 2006·Gynecologic and Obstetric Investigation·Angelos LiapisGeorgios Creatsas
Oct 20, 2006·Journal of Lower Genital Tract Disease·Roger C Andersen
Dec 18, 2007·BJOG : an International Journal of Obstetrics and Gynaecology·J E JelovsekM F R Paraiso
Feb 28, 2008·Clinical Obstetrics and Gynecology·Amy R Kane, Charles W Nager
Sep 20, 2008·The Journal of Urology·Firouz DaneshgariMia Swartz
Oct 22, 2008·International Urogynecology Journal and Pelvic Floor Dysfunction·Ph H ter MeulenPh E V A van Kerrebroeck
Nov 13, 2009·International Urogynecology Journal·Ladislav KroftaMichal Krcmár
Feb 27, 2010·International Urogynecology Journal·Jonathan P ShepherdKenneth J Smith
Mar 23, 2010·The Journal of Urology·Roger R DmochowskiLinda E Whetter
May 19, 2010·The New England Journal of Medicine·Holly E RichterUNKNOWN Urinary Incontinence Treatment Network
May 27, 2010·International Urogynecology Journal·Giovanni A TommaselliCarmine Nappi
Oct 14, 2010·BJOG : an International Journal of Obstetrics and Gynaecology·K L GuerreroM G Lucas
Mar 23, 2011·Obstetrics and Gynecology·Holly E RichterUNKNOWN Urinary Incontinence Treatment Network
Jan 25, 2012·Obstetrics and Gynecology·Matthew D BarberUNKNOWN Foundation for Female Health Awareness Research Network
Mar 29, 2012·Female Pelvic Medicine & Reconstructive Surgery·Lekha S HotaPeter L Rosenblatt
Nov 8, 2012·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Luis Gustavo Morato de ToledoSidney Glina

❮ Previous
Next ❯

Citations

Jul 25, 2017·The Cochrane Database of Systematic Reviews·Vivienne KirchinPatricia Aluko
Jul 26, 2017·The Cochrane Database of Systematic Reviews·Cathryn Ma GlazenerAtefeh Mashayekhi
Jul 26, 2017·The Cochrane Database of Systematic Reviews·Haroon RehmanPatricia Aluko
Jul 26, 2017·The Cochrane Database of Systematic Reviews·Marie Carmela M LapitanAtefeh Mashayekhi
Jul 27, 2017·The Cochrane Database of Systematic Reviews·Arjun NambiarPatricia Aluko
Feb 5, 2019·International Urogynecology Journal·Sandra ZwolsmanUNKNOWN WOMEN-UP Consortium: http://www.women-up.eu/consortium/
Aug 2, 2017·The Cochrane Database of Systematic Reviews·Cathryn Ma GlazenerAtefeh Mashayekhi
Dec 11, 2019·The Cochrane Database of Systematic Reviews·Jawad FreitesWael I Agur
Aug 2, 2017·The Cochrane Database of Systematic Reviews·Abigail A FordJoseph A Ogah
Apr 19, 2017·International Urogynecology Journal·Stefan MohrAnnette Kuhn
Jul 31, 2018·The Cochrane Database of Systematic Reviews·Nicola DeanAtefeh Mashayekhi
Nov 18, 2020·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Ziye HuangJiongming Li

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.