Economic analyses of stress urinary incontinence surgical procedures in women

Tanner Rawlings, Philippe E. Zimmern

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Introduction: To evaluate the quality of economic analysis (EA) of surgical procedures for stress urinary incontinence (SUI) in women. Methods: A MEDLINE search on EA for SUI surgical procedures for the years 2000–2014 included the MeSH terms “tension-free vaginal tape,” “TVT,” “trans-obturator tape,” “TOT,” “Burch colposuspension” (BC), “stress urinary incontinence,” “economic analysis,” and “cost-effectiveness analysis.” Important criteria for evaluating articles were selected from panels that set out criteria to evaluate EA [Scales CD, Jr., Christopher SS, American Urological Association 32:121–128, 2013], [Hsieh MH, Maxwell MV, J Urol 178 1867–1874, 2007], [Wu JM, Catherine CM, Conover MM, et al., Obstet Gynecol 123 1201–1206, 2014]. Results: Thirteen articles were identified: TVT compared to BC (6), to other surgical procedures for SUI (1), to TOT (3) and to the mini-sling (1); open BC compared to laparoscopic BC (1), and analysis of various slings and meshes for various types of incontinence (1). Articles originated from: United States (3), Europe (4), United Kingdom (4), and Canada (2). Eight described cost-effectiveness analysis (CEA), two cost-utility analysis, and three cost comparison. Follow-up time for patients ranged from 6 to 24 months in eight articles, with four having a minimum of 24 months follow-up. Studies mostly adhered to the criteria, however indirect costs, sensitivity analysis, and efficacy parameters varied. Long-term synthetic sling-related complications were not included. Conclusion: Although CEA for SUI surgery is a burgeoning field, study comparisons remain difficult due to some variability, including health care delivery systems. As women live longer, long-term data will become critical as complications and reoperations can affect the real cost of SUI corrective procedures. Neurourol. Urodynam. 35:1040–1045, 2016.

Original languageEnglish (US)
Pages (from-to)1040-1045
Number of pages6
JournalNeurourology and urodynamics
Issue number8
StatePublished - Nov 1 2016


  • Markov modeling
  • economic analysis
  • stress urinary incontinence
  • surgical procedure

ASJC Scopus subject areas

  • Clinical Neurology
  • Urology


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