Cost Analysis of Vaginal Mid Urethral Sling Suburethral Removal

Introduction: For cost analysis of mid urethral sling surgery there is a lack of data on costs associated with long-term complications. Therefore, we studied the costs related to a vaginal suburethral synthetic sling removal procedure over 2 consecutive years. Methods: From a prospectively maintained database of consecutive women who underwent 1 vaginal suburethral synthetic sling removal only, we analyzed the cost of suburethral synthetic sling removal for 2013 and 2014. Costing data were obtained for operating room expenses, medical and surgical supplies, pharmacy, anesthesia supplies, and room and bed. Professional fees for the suburethral synthetic sling removal procedure were obtained from the Medicare fee-for-service schedule. Costs for 2013 were adjusted by 3% to match 2014 costs. Results: From 2013 to 2014 a total of 46 women underwent suburethral synthetic sling removal. Mean ± SD length of surgery was 62 ± 22 minutes and median length of stay was 1 day (range 0 to 2). Costs for medical and surgical supplies decreased significantly from 2013 to 2014 while operating room and total cost increased during that time. No significant differences were found among payer types. With the 3% inflation adjustment for 2013 the mean total cost based on these factors was $3,714 ± $941, with a median cost of $3,556. Of the 46 women 13 were treated on an outpatient basis and the median cost was reduced at $3,030. Conclusions: At our tertiary care center the mean total cost of suburethral synthetic sling removal was $3,714, with a slight total cost increase from 2013 to 2014 but a cost saving for those treated as outpatients. This information will be useful for inclusion in the overall cost of mid urethral sling procedures.