To compare the cost of three vaginal procedures used in the surgical management of SUI at one tertiary institution.
The costs of autologous fascial sling (AFS), synthetic mid-urethral sling (MUS), and anterior vaginal wall suspension (AVWS) were analyzed from a prospective long-term database, with follow-up to 5 years after these procedures. Original costing data was obtained for operating room, medical and surgical supplies, pharmacy, anesthesia supplies, and room and bed over two consecutive years. Included were complete cost data provided by our institution from Medicare (2012) and private payer insurance.
For the year 2013, the AVWS, AFS and MUS had total median costs of $4,513, $5,721, and $3,311 respectively. Total cost and all sub-costs except for pharmacy costs were significantly different for each procedure. AVWS and MUS placement differed from each other regarding the cost of anesthesia and hospital stay, which was higher for AVWS. Compared to AFS, AVWS had significantly lower total costs due to decreased costs associated with operating time, hospital stay and surgical supplies (p < 0.0001). At 5 years after these procedures, synthetic slings had less frequent follow-up visits. The most common revision for SUI failure was a bulking agent injection.
Initial costs of vaginal SUI procedures at our institution fared favorably compared to SUI procedures reported in the contemporary U.S. literature. Long-term costs can vary based on physician preference in follow-up routine and etiology of SUI.

Copyright © 2020. Published by Elsevier Inc.

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