Cost Analysis of Bladder Catheterization After Pelvic Floor Surgery

Anouk Benseler; Zi Ying Zhao; Muhammad Harris Sheikh; Brian Chan; George Tomlinson; Colleen D McDermott

doi:10.1097/SPV.0000000000001519

Cost Analysis of Bladder Catheterization After Pelvic Floor Surgery

Urogynecology (Phila). 2024 May 10. doi: 10.1097/SPV.0000000000001519. Online ahead of print.

Authors

Anouk Benseler¹, Zi Ying Zhao², Muhammad Harris Sheikh², Brian Chan³, George Tomlinson⁴, Colleen D McDermott

Affiliations

¹ From the Department of Obstetrics and Gynecology.
² Faculty of Medicine, and.
³ Institute of Health Policy, Management and Evaluation, University of Toronto.
⁴ Department of Medicine, University Health Network and Mt Sinai Hospital, and Institute of Health Policy, Management and Evaluation, University of Toronto.

PMID: 38726966
DOI: 10.1097/SPV.0000000000001519

Abstract

Importance: Approximately 15-45% of female patients develop transient postoperative urinary retention (POUR) following pelvic reconstructive surgery. Catheter options for bladder drainage include transurethral indwelling catheter (TIC), intermittent self-catheterization (ISC), and suprapubic tube (SPT). Each strategy has risks and benefits; none have been shown to be clinically superior, and to date, no comprehensive comparative economic analysis has been published.

Objective: The objective of this study was to evaluate the cost of these different bladder catheterization strategies after transvaginal pelvic surgery.

Study design: A Canadian universal single-payer (government funded) health system perspective was taken, and a decision tree model was constructed to evaluate the costs associated with each catheterization strategy over a 6-week horizon. Base-cases were set based on recently published clinical data of our institutions, 2 academic tertiary care centers, and based on systematic reviews and meta-analyses. Costs were established in consultation with process stakeholders, in addition to published values.

Results: The average cost calculated for management of transient POUR after outpatient pelvic reconstructive surgery was 150.69 CAD (median 154.86; interquartile range [IQR] 131.30-176.33) for TIC, 162.28 CAD (median 164.72; IQR 144.36-189.39) for ISC and 255.67 CAD (median 270.63; IQR 234.32-276.82) for SPT. In costing inpatient surgical data, the average cost calculated was 134.22 CAD (median 123.61; IQR 108.87-151.85) for TIC and 224.61 CAD (median 216.07; IQR 203.86-231.23) for SPT.

Conclusion: TIC and ISC were found to be significantly less costly than SPT in managing transient POUR following transvaginal pelvic reconstructive surgery.