Abstract
Stress urinary incontinence (SUI) is an important public health problem that significantly reduces quality of life. Today, there is a growing trend to change the current approach of surgical treatment of SUI in woman by using simple, effective and safe techniques that tend to significantly shorten the duration of hospitalization and reduce treatment cost with faster establishment of working capacity. According to that, the application of economic principles in healthcare has the task of comparison between the therapeutic methods that account their costs, benefit and health consequences. The aim of this study was to evaluate the clinical efficacy and economic viability of obturator tension free vaginal tape (TVT-O) method for treating SUI by using the cost – benefit analysis. The study was a retrospective-prospective study, which included 60 patients who were surgically treated after having a diagnosis of SUI in the period from January 2007 to August 2010 in the Regional Hospital in Bihac. The results identify TVT-O as a method of choice in the treatment of SUI, where the benefit of TVT-O method is up to 4.2 times higher in comparison to the vaginoplasty. Analyzing the clinical efficacy showed a shorter operative time, a shorter length of hospital stay and less complications by using TVT-O method. The outcome results showed that 83% of patients were considered to be cured and 17% had improved health status after TVT-O surgery. According to the parameters of quality of life, patients treated with TVT-O procedure showed a significantly faster return to their social activities and vitalities.
Highlights
Stress urinary incontinence (SUI) represents involuntarily leak of urine in the circumstances where the pressure in the urinary bladder exceeds that of the urethra, when the activation of the detrusor fails and it represents an important public health problem since it significantly reduces the quality of life
There is a growing trend to change the current approach of surgical treatment of SUI in woman by using simple, effective and safe techniques that tend to significantly shorten the duration of hospitalization, reduce the treatment costs, faster establishment of working capacity with minimal damage to surrounding tissues and the local innervations, which decrease the number of postoperative complications and ensure the establishment of normal function (2)
If we add the total price of consummated materials during vaginoplasty, we come to a total operation price for vaginoplasty which amounts 483.26 €
Summary
Stress urinary incontinence (SUI) represents involuntarily leak of urine in the circumstances where the pressure in the urinary bladder exceeds that of the urethra, when the activation of the detrusor fails and it represents an important public health problem since it significantly reduces the quality of life. There is a growing trend to change the current approach of surgical treatment of SUI in woman by using simple, effective and safe techniques that tend to significantly shorten the duration of hospitalization, reduce the treatment costs, faster establishment of working capacity with minimal damage to surrounding tissues and the local innervations, which decrease the number of postoperative complications and ensure the establishment of normal function (2). The needle is drawn through the previously made stab wound and due to the fact that the TVT tape is carried out blindly, it is important that the surgeon knows the anatomical structures in the retropubic space, in order to prevent possible complications. Besides the possibility of damaging the urethra or the bladder, there is a possibility of violation of important vascular structures such as obturator vascular bundle. The tape is placed under the mid urethra without elevation, without fixing the ends of the tape, just cutting it below the skin section (3)
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