Cost analysis of surgical treatment for pelvic organ prolapse by laparoscopic sacrocolpopexy or transvaginal mesh

Carracedo, David Sánchez; López-Fando, Luis; Sánchez, María Dolores Martín; Jiménez, Miguel; Gómez, Jonatán Martín; Laso, I.; Rodríguez, Marta; Burgos, Francisco

doi:10.1016/j.acuroe.2016.12.006

Cited by 9 publications

(7 citation statements)

References 22 publications

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“…In terms of the operating time, data from four RCTs 18–22 and 12 NRSIs 23,24,26,27,29–31,33,35–38 included mean operative duration values (see Supplementary material, Figure S2A) and showed a shorter operative time with TVM surgeries than with SC. Two of the RCTs 20–22 lacked values for the standard deviation; hence, the pooled mean difference of operative time was not estimated.…”

Section: Resultsmentioning

confidence: 99%

“…There were 20 eligible studies, including four RCTs 18–22 (there were two articles 20,21 about one RCT), four prospective studies 23–26 and 12 restrospective studies, 27–38 identified from the MEDLINE, EMBASE, Cochrane Library and clinicaltrials.gov databases. A PRISMA flow diagram depicting the study selection process is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

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Sacrocolpopexy compared with transvaginal mesh surgery: a systematic review and meta‐analysis

Zhang

Sun

Yang

et al. 2020

BJOG

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Background The use of mesh is controversial in the treatment of female pelvic organ prolapse. Objectives To systematically review the outcomes of sacrocolpopexy compared with transvaginal mesh surgery and to provide evidence-based suggestions. Search strategy The MEDLINE, EMBASE, Cochrane Library and clinicaltrials.gov databases were searched on 21 November 2018. Selection criteria Randomised controlled trials and prospective and retrospective cohort studies were included. Data collection and analysis Data were extracted by one reviewer and examined by a second reviewer for accuracy. Odds ratios and 95% CI were calculated using random-effects models. Main results Twenty comparative studies were included. The metaanalysis was performed with subgroups. The summary odds ratios of the randomised controlled group were 1.84 (95% CI 0.79-4.29, I 2 = 75%) for anatomical success, 1.41 (95% CI 0.47-4.24, I 2 = 38%) for subjective success, 0.42 (95% CI 0.18-0.98, I 2 = 0%) for mesh complications, 0.61 (95% CI 0.20-1.91, I 2 = 0%) for prolapse reoperation and 0.44 (95% CI 0.23-0.88, I 2 = 0%) for de novo dyspareunia. The mean differences were 0.77 (95% CI 0.31-1.23, I 2 = 66%) for total vaginal length and À1.28 (95% CI À2.00 to À0.55, I 2 = 66%) for point C after surgery. Conclusions Very-low-quality evidence indicated that the anatomical and subjective success rates of sacrocolpopexy were similar to those of transvaginal mesh surgery; sacrocolpopexy might be more beneficial than transvaginal mesh surgery in terms of mesh-related complication rates, prolapse recurrence and de novo dyspareunia. However, additional high-quality randomised trials with long-term follow-up durations are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Sacrocolpopexy compared with transvaginal mesh surgery: a systematic review and meta‐analysis

Zhang

Sun

Yang

et al. 2020

BJOG

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“…The TVM group required a higher cost due to longer hospital stay and more expensive prosthetic material including mesh kits. They concluded that the cost of LSC was similar to TVM in 2017 (LSC €5985.7 vs. TVM €6534) 10 . In addition, LSC needed higher labor costs and consumables costs than TVM due to the longer operative time.…”

Section: Discussionmentioning

confidence: 99%

Cost analysis of four types of surgeries for pelvic organ prolapse in a Japanese population

Myoga

Sho

Aoki

et al. 2021

J of Obstet and Gynaecol

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Introduction and Hypothesis To compare the perioperative costs analysis between laparoscopic/transvaginal and the mesh/non–mesh surgeries for pelvic organ prolapse (POP) in Japan. Materials and Methods From April 2013 to April 2017, 890 patients who underwent POP surgeries were enrolled in this study. Regarding transvaginal native tissue repair (TV‐NTR: transvaginal hysterectomy with colpocleisis), transvaginal mesh surgery (TVM), laparoscopic native tissue repair (L‐NTR: laparoscopic hysterectomy and uterosacral ligament colposuspension), and laparoscopic sacrocolpopexy (LSC), a retrospective observational study was performed. Patients' age, operation time, blood loss, perioperative complications, length of hospital stay, pre‐/postoperative quality of life (QOL) scores, were reviewed from the medical records. The net income, which was calculated by using the income (the operation/anesthesia fee) and the costs (the labor and consumables costs for operation/anesthesia), was evaluated. Results The operation fees of the L‐NTR ($4250) and the LSC ($4833) groups were higher than that of the TV‐NTR ($2652) and the TVM ($2913) groups. The labor costs and consumables costs of operation were higher in the LSC ($1589) and the L‐NTR ($1500) groups than the TV‐NTR ($180) and the TVM ($178) groups. The consumables costs for anesthesia in the four groups were equal. The operation hours were significantly shorter in the TV‐NTR and the TVM groups than the L‐NTR and the LSC groups. Conclusions We found that TVM operation was an economically excellent and the most efficient POP operation with shorter operation time and less consumables.

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“…Although there have been studies comparing the costs of MISCP with those of transvaginal mesh-based repair, which showed that transvaginal repair has lower costs [ 9 – 11 ], there is an absence of comparative data regarding native tissue repair especially post-ERAS implementation, an intervention that has been shown to decrease hospital costs [ 12 , 13 ]. In this study, we tested our hypothesis that MISCP has higher costs from a hospital perspective than NTR for the surgical treatment of primary uterovaginal prolapse.…”

Section: Introductionmentioning

confidence: 99%

Financial analysis of minimally invasive sacrocolpopexy compared with native tissue vaginal repair with concomitant hysterectomy

et al. 2023

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Introduction Minimally invasive sacrocolpopexy (MISCP) is increasingly used for uterovaginal prolapse, but comparative cost data of MISCP versus native tissue vaginal repair (NTR) are lacking. The objective was to determine the cost difference, from a hospital perspective, between MISCP and NTR performed with hysterectomy for uterovaginal prolapse. Methods This was a retrospective cohort study at a tertiary care center of women who underwent NTR or MISCP with concomitant hysterectomy in 2021. Hospital charges, direct and indirect costs, and operating margin (revenue minus costs) were obtained from Strata Jazz and compared using SPSS. Results A total of 82 women were included, 33 MISCP (25 robotic, 8 laparoscopic) versus 49 NTR. Demographic and surgical data were similar, except that MISCP had younger age (50.5 vs 61.1 years, p <0.01). Same-day discharge and estimated blood loss were similar, but operative time was longer for MISCP (204 vs 161 min, p <0.01). MISCP total costs were higher (US$17,422 vs US$13,001, p <0.01). MISCP had higher direct costs (US$12,354 vs US$9,305, p <0.01) and indirect costs (US$5,068 vs US$3,696, p <0.01). Consumable supply costs were higher with MISCP (US$4,429 vs US$2,089, p <0.01), but the cost of operating room time and staff was similar (US$7,926 vs US$7,216, p =0.07). Controlling for same-day discharge, anti-incontinence procedures and smoking, total costs were higher for MISCP (adjusted beta = US$4,262, p <0.01). Mean charges (US$102,060 vs US$97,185, p =0.379), revenue (US$22,214 vs US$22,491, p =0.929), and operating margin (US$8,719 vs US$3,966, p =0.134) were not statistically different. Conclusion Minimally invasive sacrocolpopexy had higher costs than NTR; however, charges, reimbursement, and operating margins were not statistically significantly different between the groups.

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Cost analysis of surgical treatment for pelvic organ prolapse by laparoscopic sacrocolpopexy or transvaginal mesh

Cited by 9 publications

References 22 publications

Sacrocolpopexy compared with transvaginal mesh surgery: a systematic review and meta‐analysis

Sacrocolpopexy compared with transvaginal mesh surgery: a systematic review and meta‐analysis

Cost analysis of four types of surgeries for pelvic organ prolapse in a Japanese population

Financial analysis of minimally invasive sacrocolpopexy compared with native tissue vaginal repair with concomitant hysterectomy

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