Document Detail

Economic evaluation of three surgical interventions for menorrhagia.
MedLine Citation:
PMID:  12615829     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The study was carried out to compare the overall effectiveness and direct economic costs of vaginal hysterectomy (VH), endometrial ablation (EA) and thermo-coagulation (TC) for the treatment menorrhagia. METHODS: We treated 50, 50 and 47 women with menorrhagia (>150 points on the Higham pictorial chart) by VH, EA and TC respectively. The patients were treated consecutively by the same surgeon and the choice between the three procedures depended on the desire of the patients. Resource utilization for the interventions was collected retrospectively from the hospital charts. A study questionnaire was mailed to the patients 24-36 months after the primary surgery. Patients who reported that they had undergone a second procedure or who were still menorrhagic were considered as treatment failures. RESULTS: As expected, the failure rate was lowest for VH. The total cost (without re-intervention for persistent menorrhagia) was 5315 Euros for VH, 1098 Euros for EA and 921 Euros for TC. The total cost with re-intervention was calculated based on therapeutic strategies used in 2001 and estimated at 5321 Euros for VH, 1263 Euros for EA and 1320 Euros for TC. CONCLUSIONS: The two out-patient procedures are very comparable in terms of success rates and costs. Choices will depend on budgeting considerations, surgeon skill and patient preference. The results may give guidance to investment decisions.
Hervé Fernandez; Giséla Kobelt; Amélie Gervaise
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  18     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-04     Completed Date:  2003-10-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  583-7     Citation Subset:  IM    
Service de Gynécologie-Obstétrique, Université Paris-Sud, Hôpital Antoine Béclère (AP-HP), 157 Rue de la Porte de Trivaux, 92141 Clamart Cedex, France.
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MeSH Terms
Electrocoagulation / economics
Endometrium / surgery
Gynecologic Surgical Procedures / economics*
Health Care Costs*
Hysterectomy, Vaginal / economics
Hysteroscopy / economics
Menorrhagia / surgery*
Middle Aged
Reoperation / economics
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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