Berman C J, Kreder K J
Department of Urology, University of Iowa, Iowa City, USA.
J Urol. 1997 Jan;157(1):122-4.
We examined the cost of 2 common forms of surgical treatment of genuine stress urinary incontinence due to intrinsic sphincter deficiency, that is sling cystourethropexy and periurethral collagen injection.
Between May 1994 and July 1995, 14 women with intrinsic sphincter deficiency underwent sling cystourethropexies. A total of 14 matched patients with intrinsic sphincter deficiency underwent endoscopic collagen injection during the same period.
The total cost per treatment of fascia lata sling cystourethropexy ($10,382) was 2.1 times greater than that for collagen injection ($4,996, p < 0.001). At an average followup of 14.9 months for fascia lata cystourethropexy and 21.3 months for collagen injection, 71.4% of patients in the former and 26.7% in the latter groups were completely continent (p = 0.05). One or no pads were used daily by 85 and 40% of the patients, respectively.
Fascia lata sling cystourethropexy may be a more cost-effective surgical treatment than periurethral endoscopic collagen injection for treating genuine stress urinary incontinence in women with intrinsic sphincter deficiency when the greater success rate of the former procedure is considered.
我们研究了因固有括约肌缺陷导致的真性压力性尿失禁的两种常见手术治疗方式的成本，即吊带式膀胱尿道悬吊术和尿道周围胶原注射术。
1994年5月至1995年7月期间，14例固有括约肌缺陷的女性接受了吊带式膀胱尿道悬吊术。同期共有14例匹配的固有括约肌缺陷患者接受了内镜下胶原注射。
阔筋膜吊带式膀胱尿道悬吊术每次治疗的总成本（10382美元）是胶原注射术（4996美元，p<0.001）的2.1倍。阔筋膜膀胱尿道悬吊术的平均随访时间为14.9个月，胶原注射术为21.3个月，前者组71.4%的患者完全控尿，后者组为26.7%（p=0.05）。两组患者每天分别使用1片或不使用尿垫的比例为85%和40%。
考虑到阔筋膜吊带式膀胱尿道悬吊术成功率更高，对于治疗固有括约肌缺陷的女性真性压力性尿失禁，该手术可能比尿道周围内镜下胶原注射术更具成本效益。
