E-Posters-10173

10173_Wang

Pdf Summary

This study aimed to determine the cost-effectiveness of routine postoperative retrograde voiding trials following pelvic surgeries. A decision tree model was developed using empirical data from literature to estimate the impact of voiding trials on clinical and cost-effectiveness outcomes. Costs were estimated from the healthcare system's perspective and health benefits were measured in quality-adjusted life years (QALYs) and the number of cases of chronic voiding dysfunction avoided. Incremental cost-effectiveness ratios (ICER) were calculated to identify the most cost-effective strategy. <br /><br />The results showed that routine voiding trials are cost-effective if the incidence of voiding dysfunction is above 12.2%, and cost-saving if the incidence is above 31.1%. The cost effectiveness of voiding trials varied depending on the expected incidence of voiding dysfunction. For example, in a scenario where the expected incidence of voiding dysfunction was 10%, routine voiding trials would be cost-effective only if the willingness to pay (WTP) threshold is above $135,335 per QALY, with a cost per case of chronic voiding dysfunction avoided at $230,069. In another scenario where the expected incidence of voiding dysfunction was 20%, routine voiding trials would be cost-effective if the WTP is above $35,558 per QALY, with a cost per case of chronic voiding dysfunction avoided at $60,449. <br /><br />The study also identified that the incidence of emergency room visits for acute urinary retention and the incidence of chronic urinary retention after acute retention care had the greatest impact on cost-effectiveness. <br /><br />In conclusion, routine postoperative retrograde voiding trials can be cost-effective compared to expectant management for managing voiding dysfunction after pelvic surgeries. The findings of this study can help inform clinical guidelines and practice. However, there is still no consensus on the routine use of voiding trials following pelvic surgeries, and further research is needed in this area.

Keywords

cost-effectiveness

voiding trials

pelvic surgeries

decision tree model

incidence of voiding dysfunction

healthcare system

chronic voiding dysfunction

willingness to pay

acute urinary retention

clinical guidelines