Minimizing the cost of surgical correction of stress urinary incontinence and prolapse.

OBJECTIVES: To compare the operative costs associated with the use of incontinence kits, with or without biomaterials, with surgeon-tailored prolene mesh (STPM) in the treatment of stress urinary incontinence (SUI) with or without pelvic organ prolapse.
METHODS: All operations for uncomplicated SUI with or without pelvic organ prolapse were reviewed from 2007-2008. Operative billing sheets including operative time, hospital cost, and the insurance billing statement were obtained and reviewed. Surgeon payment was not included in the analysis. Hospital stay was also compared.
RESULTS: For patients with SUI alone, there was a significant difference in the hospital cost and the insurance billing statement between STPM and commercial kits (CK). On average, the insurance billing statement for STPM was $2220 less per case as compared with CK. For patients with SUI and anterior compartment prolapse, there was a significant difference in the hospital cost and the insurance billing statement between STPM and CK. On average, the insurance billing statement for STPM was $4770 less per case as compared with CK. For patients with SUI and anterior and posterior compartment prolapse, the difference in hospital cost and insurance billing statement approached statistical significance. The insurance billing statement for STPM on an average was $5600 less per case as compared with CK. There was no significant difference in operative time or hospital stay.
CONCLUSIONS: The use of STPM for the treatment of incontinence with or without prolapse is significantly less costly for the hospital and the patient and/or insurance as compared with CK. The use of STPM did not increase operative time or postoperative hospital stay when compared with prefashioned kits.