{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:47:52Z","timestamp":1784249272477,"version":"3.55.0"},"reference-count":18,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2004,11,1]],"date-time":"2004-11-01T00:00:00Z","timestamp":1099267200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Technol Assess Health Care"],"published-print":{"date-parts":[[2004,11]]},"abstract":"<jats:p><jats:bold>Objectives:<\/jats:bold> Stress urinary incontinence affects between 10 percent and 50 percent of women. Surgery is commonly recommended for troublesome incontinence that does not respond to nonsurgical management. Tension-free vaginal tape (TVT) is a newer, minimal access surgical sling procedure, which is being increasingly adopted worldwide. The cost-effectiveness of TVT in comparison with other surgical procedures, particularly open colposuspension, is assessed.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Effectiveness estimates came from a systematic review of TVT compared with other surgical procedures (open and laparoscopic colposuspension, traditional slings, and injectables). Deterministic and probabilistic analyses were used to assess the likelihood of TVT being cost-effective. Sensitivity analyses assessed the impact of changing assumptions about cure rates and costs for TVT, cure rates for retreatment open colposuspension, and proportions of women who choose retreatment.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Reliable estimates of relative effectiveness were difficult to derive because the few randomized controlled comparisons had not been optimally analyzed or fully reported. Results of the economic model suggested that TVT dominates open colposuspension (lower cost and same quality of life years[QALYs]) within 5 years after surgery. Stochastic analysis indicated that the likelihood of TVT being cost-effective was 100 percent if decision-makers are unwilling to pay for additional QALYs. TVT's dominance depended on the assumption fact that retreatment open colposuspension has lower cure rates than a first colposuspension.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Analysis based on current short-term data indicates dominance of TVT over open colposuspension from approximately 5 years. There is a need for longer-term follow-up data from methodologically rigorous randomized trials to provide a sounder basis for estimating the relative benefits and cost implications.<\/jats:p>","DOI":"10.1017\/s0266462304001357","type":"journal-article","created":{"date-parts":[[2008,5,6]],"date-time":"2008-05-06T11:38:09Z","timestamp":1210073889000},"page":"455-463","source":"Crossref","is-referenced-by-count":38,"title":["Cost effectiveness of tension-free vaginal tape for the surgical management of female stress incontinence"],"prefix":"10.1017","volume":"20","author":[{"given":"Mary","family":"Kilonzo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Vale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally C.","family":"Stearns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Grant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June","family":"Cody","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathryn M. A.","family":"Glazener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Wallace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsty","family":"McCormack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2004,11,1]]},"reference":[{"key":"S0266462304001357_ref002","unstructured":"Downs S , Black N .1996.Systematic review of the literature on the effectiveness of surgery for stress incontinence in women.London:Department of Public Health & Policy Publications, London School of Hygiene & Tropical Medicine;Report no. 21."},{"key":"S0266462304001357_ref010","doi-asserted-by":"crossref","unstructured":"Lapitan MC , Cody DJ .2003.Open retropubic colposuspension for urinary stress incontinence in women (Cochrane Review),In: The Cochrane Library, Issue 1,Oxford,Update Software.","DOI":"10.1002\/14651858.CD002912"},{"key":"S0266462304001357_ref009","doi-asserted-by":"crossref","unstructured":"Leach GE , Dmochowski RR , Appell RA , et al.1997 Female stress urinary incontinence clinical guidelines panel summary report on surgical management of female stress urinary incontinence.J Urol. 158:875\u2013880.","DOI":"10.1016\/S0022-5347(01)64346-5"},{"key":"S0266462304001357_ref007","unstructured":"Hunskaar S , Arnold E , Burgio K , et al.1999.Recommendations of the International Scientific Committee: The evaluation and treatment of urinary incontinence. 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TVT versus laparoscopic colposuspension. Abstract.Proceedings of the 31st Annual Meeting of the International Continence Society, 2001, September 18-21,Seoul, Korea. Abstract no 268."},{"key":"S0266462304001357_ref017","unstructured":"Ward KL , Hilton P , Browning J on behalf of the UK and Ireland TVT Trial Group.2000.Changes in quality of life following surgery with tension free vaginal tape (TVT) or colposuspension for genuine stress incontinence. Abstract.Proceedings of the 3rd Annual Meeting of the International Incontinence Society. August 28-31,Tampere, Finland."},{"key":"S0266462304001357_ref001","unstructured":"Department of Health.Hospital in-patient data.Available at: http:\/\/www.doh.gov.uk\/hes\/ ."},{"key":"S0266462304001357_ref013","doi-asserted-by":"crossref","unstructured":"Manca A , Sculpher MJ , Ward K , et al.2003 A cost-utility analysis of tension-free vaginal tape versus colposuspension for primary urodynamic stress incontinence.Br J Obstet Gynaecol. 110:255\u2013262.","DOI":"10.1046\/j.1471-0528.2003.02215.x"},{"key":"S0266462304001357_ref014","unstructured":"Lehrer B , Ellis G , Carey M , et al.2002.Laparoscopic colposuspension for urinary incontinence in women (Cochrane Review)in: The Cochrane Library Issue 2,Oxford,Update Software."}],"container-title":["International Journal of Technology Assessment in Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0266462304001357","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T15:56:58Z","timestamp":1557158218000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0266462304001357\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,11]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2004,11]]}},"alternative-id":["S0266462304001357"],"URL":"https:\/\/doi.org\/10.1017\/s0266462304001357","relation":{},"ISSN":["0266-4623","1471-6348"],"issn-type":[{"value":"0266-4623","type":"print"},{"value":"1471-6348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,11]]}}}