Laparoscopic colposuspension Is it cost-effective?

Abstract

The laparoscopic surgical approach is safe and effective and by no means more expensive than the open approach. In the future, the laparoscopic approach can only become more cost efficient; techniques will improve and there will be earlier returns to work and, subsequently, greater productivity.

Cost‐effectiveness analysis of open colposuspension versus laparoscopic colposuspension in the treatment of urodynamic stress incontinence

“…This result agrees broadly with the findings of other studies in the area. [3][4][5] Over the same period, increases in mean QALYs favour the laparoscopic group, but the differential mean is small, which is a similar finding to other comparisons of laparoscopic-assisted (or minimally invasive 33 ) surgery with open surgery. 9 Our findings suggest that, in the 6 months after surgery, laparoscopic colposuspension surgery is unlikely to be cost effective when compared with open surgery, even if use of reusable equipment is taken into account.…”

“…2 However, previous economic analyses of these two colposuspension techniques are methodologically weak and have not been conducted as part of published randomised controlled trials. [3][4][5] Furthermore, since most economic analyses were carried out for other healthcare systems, the relevance of their results to the UK NHS decision-making process is unclear.…”

Laparoscopic versus open colposuspension for urodynamic stress incontinence

“…The literature search identi¢ed 16 studies comparing the results of LC to OC for patients with SUI. These studies, published between 1995 and 2006 matched the selection criteria and were included in the analysis [Polascik, 1995;Burton, 1997;Kohli, 1997;Loveridge, 1997;Su, 1997;Miannay, 1998;Saidi, 1998;Summitt, 2000;Fatthy, 2001;Walter, 2002;Cheon et al, 2003;Ankardal, 2004Ankardal, , 2005Bezerra, 2004;Huang and Yang, 2004;Smith, 2005]. Analysis was performed on 16 studies, reporting on 1,807 patients, of whom 861 (47.6%) underwent laparoscopic and 946 (52.4%) underwent OC.…”

“…Traditional Burch OC was performed in the standard fashion. Three studies [Polascik, 1995;Loveridge, 1997;Ankardal, 2004] did not require patients to have pre-operative urodynamics. Five studies [Polascik, 1995;Loveridge, 1997;Miannay, 1998;Walter, 2002;Bezerra, 2004] Conversion to open surgery was reported in 26 cases out of 460 (5.7%), among seven studies [Burton, 1997;Saidi, 1998;Fatthy, 2001;Walter, 2002;Ankardal, 2004Ankardal, , 2005.…”

“…In the remaining seven studies data collection for both groups was retrospective. Seven retrospective studies included matched groups [Polascik, 1995;Kohli, 1997;Loveridge, 1997;Miannay, 1998;Saidi, 1998;Bezerra, 2004;Huang and Yang, 2004], as follows: age [Polascik, 1995;Kohli, 1997;Loveridge, 1997;Miannay, 1998;Saidi, 1998;Bezerra, 2004;Huang and Yang, 2004], parity [Kohli, 1997;Loveridge, 1997;Miannay, 1998;Saidi, 1998;Bezerra, 2004;Huang and Yang, 2004], menopausal state [Saidi, 1998;Bezerra, 2004;Huang and Yang, 2004], HRT use [Saidi, 1998;Bezerra, 2004], previous abdomino-pelvic surgery [Polascik, 1995;Kohli, 1997;Loveridge, 1997;Miannay, 1998;Huang and Yang, 2004] and detrusor instability [Polascik, 1995;Bezerra, 2004].…”