Outcome and Cost Analysis of Sacral Nerve Modulation for Treating Urinary and/or Fecal Incontinence

被引：45

作者：

Leroi, Anne-Marie ^{[1
]}

Lenne, Xavier ^{[2
]}

Dervaux, Benoit ^{[3
]}

Chartier-Kastler, Emmanuel ^{[4
]}

Mauroy, Brigitte ^{[5
]}

Le Normand, Loic ^{[6
]}

Grise, Philippe ^{[7
]}

Faucheron, Jean-Luc ^{[8
]}

Parc, Yann ^{[9
]}

Lehur, Paul-Antoine ^{[10
]}

Mion, Francois ^{[11
]}

Damon, Henri ^{[11
]}

Barth, Xavier ^{[11
]}

Leriche, Albert ^{[12
]}

Saussine, Christian ^{[13
]}

Guy, Laurent ^{[14
]}

Haab, Francois ^{[15
]}

Bresler, Laurent ^{[16
]}

Sarramon, Jean-Pierre ^{[17
]}

Bensadoun, Henri ^{[18
]}

Rullier, Eric ^{[19
]}

Slim, Karem ^{[20
]}

Sielezneff, Igor ^{[21
]}

Mourey, Eric ^{[22
]}

Ballanger, Philippe ^{[23
]}

Michot, Francis ^{[1
]}

机构：

[1] Rouen Univ Hosp, ADEN EA 3234, IFRMP 23, Rouen, France

[2] Lille Univ Hosp, Secteur PMSI, Catholic Univ Lille, CRESGE LEM CNRS URA 362, Lille, France

[3] Univ Lille 2, Fac Med, DRCI Lille Univ Hosp, Lille, France

[4] Pierre & Marie Curie Med Sch, Dept Urol, Paris, France

[5] Lille Univ Hosp GHICL, Dept Urol, Lille, France

[6] Nantes Univ Hosp, Dept Urol, Nantes, France

[7] Rouen Univ Hosp, Dept Urol, Rouen, France

[8] Grenoble Univ Hosp, Dept Digest Surg, Grenoble, France

[9] Hop St Antoine, Dept Digest Surg, F-75571 Paris, France

[10] Nantes Univ Hosp, Digest Surg Dept, Nantes, France

[11] Hop Edouard Herriot, Digest Physiol Dept, Lyon, France

[12] Univ Lyon 1, Henry Gabrielle Hosp, Dept Urol, F-69365 Lyon, France

[13] Strasbourg Univ Hosp, Dept Urol, Strasbourg, France

[14] Clermont Ferrand Univ, Montpied Hosp, Dept Urol, Clermont Ferrand, France

[15] Tenon Hosp, Dept Urol, Paris, France

[16] Nancy Univ Hosp, Dept Digest Surg, Nancy, France

[17] Hop Rangueil, Dept Urol, Toulouse, France

[18] Caen Univ Hosp, Dept Urol, Caen, France

[19] Bordeaux Univ Hosp, Dept Digest Surg, Bordeaux, France

[20] Clermont Ferrand Univ Hosp, Dept Digest Surg, Clermont Ferrand, France

[21] Hop St Marguerite, Dept Digest Surg, Marseille, France

[22] Le Bocage Hosp, Dept Urol, Dijon, France

[23] Hop Pellegrin, Dept Urol, Bordeaux, France

来源：

ANNALS OF SURGERY | 2011年 / 253卷 / 04期

关键词：

QUALITY-OF-LIFE; STIMULATION; WOMEN; NEUROMODULATION; PREVALENCE; HEALTH; EPIDEMIOLOGY; INSTRUMENT;

D O I：

10.1097/SLA.0b013e318210f1f4

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: Sacral nerve modulation (SNM) is an established treatment for urinary and fecal incontinence in patients for whom conservative management has failed. Objective: This study assessed the outcome and cost analysis of SNM compared to alternative medical and surgical treatments. Methods: Clinical outcome and cost-effectiveness analyses were performed in parallel with a prospective, multicenter cohort study that included 369 consecutive patients with urge urinary and/or fecal incontinence. The duration of follow-up was 24months, and costs were estimated from the national health perspective. Cost-effectiveness outcomes were expressed as incremental costs per 50% of improved severity scores (incremental cost-effectiveness ratio). Results: The SNM significantly improved the continence status (P < 0.005) and quality of life (P < 0.05) of patients with urge urinary and/or fecal incontinence compared to alternative treatments. The average cost of SNM for urge urinary incontinence was (sic) 8525 (95% confidence interval, (sic) 6686 (sic) 10,364; P = 0.001) more for the first 2 years compared to alternative treatments. The corresponding increase in cost for subjects with fecal incontinence was (sic) 6581 (95% confidence interval, (sic) 2077 (sic) 11,084; P = 0.006). When an improvement of more than 50% in the continence severity score was used as the unit of effectiveness, the incremental cost-effectiveness ratio for SNM was (sic) 94,204 and (sic) 185,160 at 24 months of follow-up for urinary and fecal incontinence, respectively. Conclusions: The SNM is a cost-effective treatment for urge urinary and/or fecal incontinence.

引用

页码：720 / 732

页数：13

共 41 条

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