Department of Urology, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York, NY 10065, USA.
BJU Int. 2013 Jul;112(2):E151-8. doi: 10.1111/bju.12180. Epub 2013 Jun 14.
To compare the cost-effectiveness (CE) of tension-free vaginal tape (TVT) with that of burch colposuspension (BC) for the treatment of female stress urinary incontinence (SUI).
A Markov-chain decision model was created to simulate treatment of SUI with TVT or BC using Treeage Pro 2011 software (Treeage Software Inc., Williamstown, MA, USA). Costing data were obtained from the Medicare Resource-Based Relative Value Scale. Data regarding the success of TVT vs BC were obtained from the peer-reviewed literature, as were corresponding utilities for different continence states. The CE of each procedure was calculated and compared, and sensitivity analyses were performed.
At 10-year follow-up, TVT was more cost-effective (CE = $1495/quality-adjusted life year [QALY]) than BC (CE = $1824/QALY). Sensitivity analysis showed that TVT was more cost-effective than BC if the cost of the TVT device was <$3220. If the probability of success after TVT was <42%, then BC became the more cost-effective strategy (CE = $1827/QALY).
Our study showed that TVT was more cost-effective than BC as a treatment for female SUI. Both cost of TVT device and efficacy of the procedure affect the CE analysis.
比较经阴道无张力吊带术（TVT）与耻骨后膀胱颈悬吊术（BC）治疗女性压力性尿失禁（SUI）的成本效果。
采用 Treeage Pro 2011 软件（美国马萨诸塞州威廉斯敦的 Treeage Software Inc.）创建 Markov 链决策模型，模拟 TVT 或 BC 治疗 SUI。成本数据来自 Medicare 资源基础相对价值量表。TVT 与 BC 成功率的数据来自同行评议文献，不同控尿状态的相应效用值也来自文献。计算并比较了两种手术的成本效果，并进行了敏感性分析。
在 10 年随访时，TVT 的成本效果（CE = $1495/质量调整生命年[QALY]）优于 BC（CE = $1824/QALY）。敏感性分析显示，如果 TVT 装置的成本<$3220，则 TVT 比 BC 更具成本效果。如果 TVT 后的成功率<42%，则 BC 成为更具成本效果的策略（CE = $1827/QALY）。
我们的研究表明，TVT 是治疗女性 SUI 更具成本效果的方法。TVT 装置的成本和手术的疗效均会影响成本效果分析。
