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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Manchester-Fothergill procedure versus vaginal hysterectomy with uterosacral ligament suspension: an activity-based costing analysis

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  1. The urethral closure mechanism is deteriorated after anterior colporrhaphy

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  2. Influence of body mass index on short-term subjective improvement and risk of reoperation after mid-urethral sling surgery

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  3. Predictors and reasons for help-seeking behavior among women with urinary incontinence

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  1. Effect of imipramine on urethral opening pressure: A randomized, double-blind, placebo-controlled crossover study in healthy women

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  2. Pelvic organ prolapse and urogynecological assessment in women with spinal cord injury

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  3. Perioperative cardiovascular complications following urogynecological operations

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  4. Prevalence of urinary incontinence in women with spinal cord injury

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INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) is a common diagnosis that imposes high and ever-growing costs to the healthcare economy. Numerous surgical techniques for the treatment of POP exist, but there is no consensus about which is the ideal technique for treating apical prolapse. The aim of this study was to estimate hospital costs for the most frequently performed operation, vaginal hysterectomy with uterosacral ligament suspension (VH) and the uterus-preserving Manchester-Fothergill procedure (MP), when including costs of postoperative activities.

METHODS: The study was based on a historical matched cohort including 590 patients (295 pairs) who underwent VH or MP during 2010-2014 owing to apical prolapse. The patients were matched according to age and preoperative prolapse stage and followed for a minimum of 20 months. Data were collected from four national registries and electronic medical records. Unit costs were obtained from relevant departments, hospital administration, calculated, or estimated by experts. The hospital perspective was applied for costing the resource use.

RESULTS: Total costs for the first 20 months after operation were 3,514 € per VH patient versus 2,318 € per MP patient. The cost difference between the techniques was 898 € (95% confidence interval [CI]: 818-982) per patient when analyzing the primary operation only and 1,196 € (CI: 927-1,465) when including subsequent activities within 20 months (p < 0.0001).

CONCLUSIONS: The MP is substantially less expensive than the commonly used VH from a 20-month time perspective. Healthcare costs can be reduced by one third if MP is preferred over VH in the treatment of apical prolapse.

Original languageEnglish
JournalInternational Urogynecology Journal
Volume29
Issue number8
Pages (from-to)1161-1171
Number of pages11
ISSN0937-3462
DOIs
Publication statusPublished - Aug 2018

    Research areas

  • Cohort Studies, Denmark, Female, Hospital Costs, Humans, Hysterectomy, Vaginal/economics, Ligaments, Organ Sparing Treatments/economics, Pelvic Organ Prolapse/economics, Treatment Outcome

ID: 56368567