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巴西公立医院压力性尿失禁手术治疗的成本分析,比较经耻骨后膀胱颈悬吊术(Burch 术)和合成吊带术。

Costs analysis of surgical treatment of stress urinary incontinence in a brazilian public hospital, comparing burch and synthetic sling techniques.

机构信息

Serviço de Ginecologia do Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brasil.

Hospital Moinhos de Vento, Porto Alegre, RS, Brasil.

出版信息

Int Braz J Urol. 2018 Jan-Feb;44(1):109-113. doi: 10.1590/S1677-5538.IBJU.2017.0232.

Abstract

INTRODUCTION

Surgical treatment of urinary incontinence progressed significantly with the introduction of synthetic slings. However, in some public Brazilian hospitals, the costs of these materials prevent their routine use.

OBJECTIVE

To compare the costs of ambulatory synthetic sling surgery with an historical series of patients submitted to Burch surgery in a Brazilian public hospital.

MATERIALS AND METHODS

Twenty nine incontinent patients were selected to synthetic sling surgery. Demographic data were prospectively collected and also the costs of the procedure, including drugs and materials, use of surgical and recovery wards, medical staff and hospitalization. These data were compared to the costs of 29 Burch surgeries performed before the introduction of synthetic slings.

RESULTS

Demographic data were similar, although median age was lower in the group submitted to Burch surgery (46.3±8.6 versus 56.2±11.3 (p<0.001)). Cost was significantly lower in patients submitted to sling in all items, except for time spent in recovery ward. Total value of 29 Burch surgeries was R$ 217.766.12, and of R$ 68.049.92 of 29 patients submitted to sling surgery (p<0.001).

CONCLUSION

Burch surgery was more expensive than ambulatory synthetic transobturator sling surgery, even when the cost of the synthetic sling was considered.

摘要

引言

随着合成吊带的引入,尿失禁的手术治疗取得了显著进展。然而,在一些巴西公立医院,这些材料的成本使其无法常规使用。

目的

比较巴西公立医院门诊使用合成吊带手术与历史系列患者行 Burch 手术的成本。

材料与方法

选择 29 例尿失禁患者行合成吊带手术。前瞻性收集人口统计学数据,包括手术费用、药物和材料费用、手术和恢复病房使用、医务人员和住院费用。将这些数据与在引入合成吊带之前进行的 29 例 Burch 手术的成本进行比较。

结果

人口统计学数据相似,但接受 Burch 手术的患者组的中位年龄较低(46.3±8.6 岁 vs. 56.2±11.3 岁(p<0.001))。除恢复病房的停留时间外,接受吊带手术的患者在所有项目的成本均显著降低。29 例 Burch 手术的总费用为 217766.12 雷亚尔,29 例接受吊带手术的患者的费用为 68049.92 雷亚尔(p<0.001)。

结论

即使考虑合成吊带的成本,Burch 手术也比门诊使用合成经闭孔吊带手术更昂贵。

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