Managing female urinary incontinence: A regional prospective analysis of cost-utility ratios (curs) and effectiveness


Submitted: July 9, 2014
Accepted: July 9, 2014
Published: June 30, 2014
Abstract Views: 1855
PDF: 1059
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Authors

  • Elisabetta Costantini Department of Medical-Surgical Specialties and Public Health, Urology and Andrology Section, University of Perugia, Perugia, Italy.
  • Massimo Lazzeri Department of Medical-Surgical Specialties and Public Health, Urology and Andrology Section, University of Perugia, Perugia, Italy.
  • Vittorio Bini Department of Internal Medicine, University of Perugia, Perugia, Italy.
  • Alessandro Zucchi Department of Medical-Surgical Specialties and Public Health, Urology and Andrology Section, University of Perugia, Perugia, Italy.
  • Emanuele Scarponi Department of Medical-Surgical Specialties and Public Health, Urology and Andrology Section, University of Perugia, Perugia, Italy.
  • Massimo Porena Department of Medical-Surgical Specialties and Public Health, Urology and Andrology Section, University of Perugia, Perugia, Italy.
Introduction: To evaluate the cost-utility of incontinence treatments, particularly anticholinergic therapy, by examining costs and quality-adjusted life years. Materials and methods: A prospective cohort study of women who were consecutively referred by general practitioners (GPs) to the Urology Department because of urinary incontinence. The primary outcome was evaluation of the cost-utility of incontinence treatments (surgery, medical therapy and physiotherapy) for stress and/or urgency incontinence by examining costs and quality-adjusted life years. Results: 137 consecutive female patients (mean age 60.6 ± 11.6; range 36-81) were enrolled and stratified according to pathologies: SUI and UUI. Group A: SUI grade II-III: 43 patients who underwent mid-urethral sling (MUS); Group B: SUI grade I-II 57 patients who underwent pelvic floor muscle exercise and Group C: UUI: 37 patients who underwent antimuscarinic treatment with 5 mg solifenacin daily. The cost utility ratio (CUR) was estimated as saving more than €1200 per QALY for surgery and physiotherapy and as costing under € 100 per QALY for drug therapy. Conclusions: This study shows that appropriate diagnosis and treatment of a patient with incontinence lowers National Health Service costs and improves the benefits of treatment and quality of life.

Costantini, E., Lazzeri, M., Bini, V., Zucchi, A., Scarponi, E., & Porena, M. (2014). Managing female urinary incontinence: A regional prospective analysis of cost-utility ratios (curs) and effectiveness. Archivio Italiano Di Urologia E Andrologia, 86(2), 112–117. https://doi.org/10.4081/aiua.2014.2.112

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