Cost-analyzes based on a prospective, randomized study comparing laparoscopic colposuspension with a tension-free...

The aim of this study was to compare laparoscopic colposuspension with tension-free vaginal tape (TVT) in terms of costs to the county.

In a prospective, randomized study, we approached 270 consecutive women presenting for evaluation of stress urinary incontinence symptoms at one university hospital. Preoperatively, and at 1-year follow-up, the women underwent urodynamic evaluation, an ultra-short pad-test and completed a lower urinary tract symptoms questionnaire. We randomized 79 consenting, eligible women to either procedure; a 1-year follow-up examination was performed on 68/71 (96%) women that were available. The procedures were performed as described previously. Main outcome measures were all relevant costs for goods and services associated with the procedures.

The baseline characteristics of the two groups were similar. The TVT procedure was performed significantly faster than the laparoscopic colposuspension, i.e. 44.9 +/- 14.2 min compared with 60.5 +/- 13.4 min (p < 0.0001). Even so, procedural costs were significantly lower for laparoscopic colposuspension than for TVT (euro 1273.4 compared with euro 1342.8 p < 0.001). At the 1-year follow-up visit, three women operated on with TVT and one operated on with laparoscopic colposuspension required re-operation for continuous stress urinary incontinence. One women operated on with TVT had her sling cut for bladder-emptying problems. Total costs, including re-operations were euro 1462.6 for a TVT procedure andeuro; 1314.5 for a laparoscopic colposuspension.

In our hands, the laparoscopic colposuspension was less expensive to the county than the TVT procedure.