{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:12:45Z","timestamp":1781651565327,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T00:00:00Z","timestamp":1676419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["80\u201084300\u201098\u201071047"],"award-info":[{"award-number":["80\u201084300\u201098\u201071047"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the cost\u2010effectiveness of urethral bulking polydimethylsiloxane\u2010Urolastic\u00ae (PDMS\u2010U) compared with mid\u2010urethral sling (MUS) surgery for stress urinary incontinence (SUI) at 1\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective, two\u2010arm cohort study with 2\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>International multicentre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women with moderate to severe SUI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Primary outcome was subjective cure (Patient Global Impression of Improvement). Secondary outcomes: objective cure (negative cough stress test), Urogenital Distress Inventory (UDI\u20106), complications and re\u2010interventions. Cost\u2010effectiveness outcomes: total costs, quality\u2010adjusted life year (QALY) using IIQ7\u2010scores (Incontinence Impact Questionnaire) and EQ\u20105D\u20105L, incremental cost\u2010effectiveness ratio (ICER) and monetary benefit (adjusted for baseline confounders).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 131 PDMS\u2010U and 153 MUS surgery patients were treated. Subjective cure rates for MUS surgery and PDMS\u2010U were, respectively: 101\/112 (90%) versus 40\/87 (46%), adjusted odds ratio (aOR; for age, body mass index [BMI], severity, type of urinary incontinence and previous SUI procedure) was 4.9. Objective cure rates for MUS surgery and PDMS\u2010U were respectively: 98\/109 (90%) versus 58\/92 (63%), aOR 5.4. Average total costs for PDMS\u2010U and MUS surgery were \u20ac3567 and \u20ac6688. ICER for MUS surgery cost \u20ac15\u2009598 per IIQ QALY and \u20ac37\u2009408 per EQ\u20105D\u20105L QALY. With a willingness to pay (WTP) of \u20ac25\u2009000, MUS has a 84% chance of being cost\u2010effective using IIQ, whereas PDMS\u2010U has a 99% chance of being cost\u2010effective using EQ\u20105D\u20105L.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MUS surgery is more cost\u2010effective in realising improved disease\u2010specific quality of life (QoL), while PDMS\u2010U is more cost\u2010effective in realising improved generic QoL.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17396","type":"journal-article","created":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T08:38:06Z","timestamp":1674203886000},"page":"674-683","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cost\u2010effectiveness of urethral bulking polydimethylsiloxane\u2010Urolastic\u00ae compared with mid\u2010urethral sling surgery for stress urinary incontinence: A two\u2010arm cohort study"],"prefix":"10.1111","volume":"130","author":[{"given":"Fenne M.","family":"Casteleijn","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC, Univ of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allert M.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Urology Radboud University Medical Centre  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le Mai","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Urology University of Sherbrooke  Sherbrooke Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P. 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