Cost-effectiveness analysis of tension-free vaginal tape vs burch colposuspension for female stress urinary incontinence in the USA


Correspondence: Richard K. Lee, Weill Cornell Medical College, Department of Urology, 425 East 61st Street, New York, NY 10065, USA.




  • To compare the cost-effectiveness (CE) of tension-free vaginal tape (TVT) with that of burch colposuspension (BC) for the treatment of female stress urinary incontinence (SUI).

Materials and Methods

  • A Markov-chain decision model was created to simulate treatment of SUI with TVT or BC using Treeage Pro 2011 software (Treeage Software Inc., Williamstown, MA, USA).
  • Costing data were obtained from the Medicare Resource-Based Relative Value Scale.
  • Data regarding the success of TVT vs BC were obtained from the peer-reviewed literature, as were corresponding utilities for different continence states.
  • The CE of each procedure was calculated and compared, and sensitivity analyses were performed.


  • At 10-year follow-up, TVT was more cost-effective (CE = $1495/quality-adjusted life year [QALY]) than BC (CE = $1824/QALY).
  • Sensitivity analysis showed that TVT was more cost-effective than BC if the cost of the TVT device was <$3220.
  • If the probability of success after TVT was <42%, then BC became the more cost-effective strategy (CE = $1827/QALY).


  • Our study showed that TVT was more cost-effective than BC as a treatment for female SUI.
  • Both cost of TVT device and efficacy of the procedure affect the CE analysis.