A Comparative Analysis of Surgery and Radiofrequency Therapy for Urinary Incontinence in Iranian Women: Health-Related Quality of Life Improvements and Short- Term Cost-Utility Analyses

Leila Moazzemi  Goudarzi; Ali  Darvishi; Lida  Shams; Ali  Maher; Rajabali  Daroudi; Sudabeh  Darvish bon

doi:10.18502/htaa.v10i1.21561

Leila Moazzemi Goudarzi Department of Health Policy and Management, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Ira
Ali Darvishi Department of Health Policy and Management, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Ira
Lida Shams Department of Health Policy and Management, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Ali Maher Department of Health Policy and Management, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Rajabali Daroudi Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
Sudabeh Darvish bon Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/htaa.v10i1.21561

Keywords: Urinary incontinence, Surgery, Radiofrequency, Health-related quality of life, Cost-utility analysis

Abstract

Introduction: This study evaluated the health-related quality of life (HRQOL) outcomes and the short-term cost-utility of surgery versus radiofrequency (RF) in treating urinary incontinence (UI) among Iranian women.

Methods: This prospective non-randomized cohort study with economic evaluation assessed the cost-utility of surgery versus RF from the Iranian health system’s perspective. HRQOL was measured using the EuroQol five-dimensional five-level (EQ-5D-5L) and PRAFAB Urinary Incontinence questionnaires, with data collected from 79 women with UI before and three months after the intervention. Costs were calculated based on hospital records. The final outcome was the quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER) was calculated.

Results: The study sample had an average age of 51.43 years. Surgical intervention led to a significant improvement in HRQOL, with a mean utility increase from 0.21 to 0.70 and a decrease in PRAFAB incontinence severity scores. RF treatment also improved HRQOL, with utility increasing from 0.50 to 0.86. Moreover, the mean cost of surgery was USD2,200, significantly higher than that of RF, which was USD 622.52. The ICER for surgery compared to RF was USD12,724.93, indicating that surgery is cost-effective.

Conclusion: Surgery and RF both improve HRQOL, with surgery offering a greater QALY gain at a higher cost. Overall, surgery is a cost-effective treatment option compared to RF, supporting its inclusion in treatment guidelines.