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COST EFFECTIVENESS OF RADIOFREQUENCY MICROREMODELING FOR STRESS URINARY INCONTINENCE
` TABLE OF CONTENTS
Cover page
Title page
Certification – – – – – – – – i
Dedication – – – – – – – – – ii
Acknowledgement – – – – – – – iii
Abstract – – – – – – – – – v
Table of contents – – – – – – – – vi
CHAPTER ONE: INTRODUCTION
1.1 Background of the Study – – – – – 1
1.2 Statement of Problem – – – – – – 7
1.3 Purpose of the study – – – – – 8
1.4 Objective of the Study – – – – – – 9
1.4 Research Questions – – – – – – 10
1.5 Research Hypothesis – – – – – – 10
1.6 Significance of the Study – – – – – 11
1.7 Scope of the study – – – – – – 11
1.8 Limitation of the study – – – – –
1.9 Definition of Terms – – – – – 12
CHAPTER TWO: REVIEW OF RELATED LITERATURE
2.1 Introduction – – – – – – – 14
2.2 The Theoretical frame Work – – – – – 21
2.3 conceptual frame work
2.4 empirical review
CHAPTER THREE: RESEARCH METHODOLOGY
3.1 Introduction – – – – – – – 82
3.2 Area of the study – – – – – – 82
3.3 Research Design – – – – – – 82
3.4 Sample and sampling techniques – – – – 83
3.5 Population of the study – – – – – 84
3.6 Procedure for Data Collection – – – – 85
3.7 Method of Data Analysis – – – – – 85
CHAPTER FOUR: PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA
4.1 Introduction – – – – – – – 87
4.2 Presentation of Data – – – – – 87
4.3 Data Analysis – – – – – – – 88
4.4 Testing of Hypothesis – – – – – 91
4.5 Discussion and summary of findings – – 94
CHAPTER FIVE:
INTRODUCTION, SUMMARY, RECOMMENDATIONS AND CONCLUSION
5.0 Introduction – – – – – – – 98
5.1 Summary – – – – – – – 99
5.2 Conclusion – – – – – – – – 100
5.3 Recommendations – – – – – – 101
REFERENCES
Appendix
Questionnaire
Abstract
Introduction and hypothesis: Stress urinary incontinence (SUI) is a common and growing problem among adult women and affects individuals and society through decreased quality of life (QoL), decreased work productivity, and increased health care costs. A new, nonsurgical treatment option has become available for women who have failed conservative therapy, but its cost effectiveness has not been evaluated. This study examined the cost effectiveness of transurethral radiofrequency microremodeling of the female bladder neck and proximal urethra compared with synthetic transobturator tape (TOT), retropubic transvaginal tape (TVT) sling, and Burch colposuspension surgeries for treating SUI.
Methods: A Markov model was used to compare the cost effectiveness of five strategies for treating SUI for patients who had previously failed conservative therapy. The strategies were designed to compare the value of starting with a less invasive treatment. The cost-effectiveness analysis was conducted from the health care system perspective. Efficacy and adverse event rates were obtained from the literature; reimbursement costs were based on Medicare fee schedule. The model cycle was 3 months, with a 3-year time horizon. Single-variable sensitivity analyses were conducted to assess stability of base-case results.
Results: Two of the five strategies employed the use of transurethral radiofrequency microremodeling and achieved 17-30 % lower mean costs relative to their comparative sling or Burch strategies.
Conclusions: Superior safety and cost effectiveness are recognized when patients are offered a sequential approach to SUI management that employs transurethral radiofrequency microremodeling before invasive surgical procedures. This sequential approach is consistent with treatment strategies for other conditions and offers a solution for women with SUI who want to avoid the inherent risks and costs of invasive continence surgery.
