Skip to main content

Trans-obturator tape compared with tension-free vaginal tape in the surgical treatment of stress urinary incontinence: a cost utility analysis

Buy Article:

$51.00 plus tax (Refund Policy)

Abstract:

Please cite this paper as: Lier D, Ross S, Tang S, Robert M, Jacobs P, for the Calgary Women’s Pelvic Health Research Group. Trans-obturator tape compared with tension-free vaginal tape in the surgical treatment of stress urinary incontinence: a cost utility analysis. BJOG 2011;118:550–556. Objective 

To conduct an economic evaluation of the use of trans-obturator tape (TOT) compared with tension-free vaginal tape (TVT) in the surgical treatment of stress urinary incontinence (SUI) in women. Design 

Cost utility analysis from public-payer perspective, conducted alongside a randomised clinical trial (RCT). Setting 

Health services provided in Alberta, Canada. Population 

A total of 194 women who participated in the RCT, followed to 1 year from surgery. Methods 

Data collected on all women in the RCT, over 12 months following surgery. Comparisons undertaken between RCT groups for cost and quality-adjusted life-years (QALYs). Multiple imputation used for the 10% missing data. Bootstrapping used to account for sampling uncertainty. One-way sensitivity analysis conducted for productivity loss due to time away from work. Main outcome measures 

Utility – 15D questionnaire was used to calculate QALYs. Costs over 12 months—from trial data, health provider and provincial ministry of health. Results 

The TOT group had a non-significant average saving of $1133 (95% CI −2793; 442), with no difference in average QALYs between groups (95% CI −0.02; 0.01). TOT was cost-saving in over 80% of bootstrapping replications, over a wide range of willingness-to-pay. Conclusion 

The bootstrapping replication results suggest that TOT could be cost-effective compared with TVT in the treatment of SUI. However, these results must be confirmed by longer-term assessment of clinical and economic outcomes, because of concern that surgical tape palpable at 12 months may lead to vaginal erosion and further treatment.

Keywords: Stress/surgery; suburethral slings; treatment outcome; urinary incontinence

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1471-0528.2010.02845.x

Affiliations: 1: Department of Obstetrics and Gynaecology 2: Institute of Health Economics, Edmonton, AB, Canada

Publication date: April 1, 2011

bsc/bjo/2011/00000118/00000005/art00004
dcterms_title,dcterms_description,pub_keyword
6
5
20
40
5

Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more