***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIMS To compare the cost-effectiveness ( CE ) of retropubic midurethral sling ( RMS ) versus transobturator midurethral sling ( TMS ) for the treatment of female stress urinary incontinence ( SUI ) . METHODS A Markov chain decision model was created to simulate treatment of SUI with RMS versus TMS .  Costing data were obtained from the Medicare RBRVS . Data regarding the efficacy and complications associated with RMS versus TMS was compiled from a literature review of 21 r and omized RCTs with a minimum of 12 months follow-up , as were corresponding utilities for different continence states . Deterministic and probabilistic estimates of cost-effectiveness ( CE ) for each procedure were calculated and compared , and sensitivity analyses were performed . RESULTS In the base-case deterministic analysis , the efficacy of RMS was 6.275 versus 6.272 QALYs for TMS . QALYs represent a measure of disease burden accounting for both quantity and quality of life lived and are used to assess the monetary value of a medical intervention . The average cost for treatment with  RMS however was higher at $ 9,579 versus $ 9,017 with TMS . TMS was therefore overall more cost-effective than RMS ( CE = $ 1,438/QALY vs. $ 1,527/QALY ) . Sensitivity analysis demonstrated that physician and sling characteristics such as device cost , surgeon fee , efficacy of treatment , operative time , and duration of hospitalization could all affect the relative CE of the therapies . CONCLUSIONS Our study demonstrated that TMS was more cost-effective than RMS as a treatment for female SUI . The efficacy of the two treatments could be affected by physician and sling characteristic factors Background . Evaluation of cost‐effectiveness of new surgical techniques is important . As the data on incontinence procedures are scarce , we evaluated the cost‐effectiveness of tension‐free vaginal tape procedure and laparoscopic mesh colposuspension as a primary surgical treatment for female stress urinary incontinence . Methods . In four university teaching hospitals and two central hospitals 128 stress incontinent women were r and omized to tension‐free vaginal tape procedure ( n = 70 ) or laparoscopic mesh colposuspension ( n = 51 ) in order to investigate the clinical performance of these two procedures . Primary objective clinical outcome measures were : stress test and 48‐h pad test . Secondary subjective outcome measures were health‐related quality of life measured in terms of visual analogue scale and Urinary Incontinence Severity Score . Alongside the clinical trial , a cost‐effectiveness analysis for the main outcome measures was performed . Results . The changes in the 48‐h pad test result did not reach statistical significance ( p = 0.105 ) . When the visual analogue scale or Urinary Incontinence Severity Score are used as the outcome measure , the tension‐free vaginal tape is more cost‐effective  than laparoscopic mesh colposuspension over a follow‐up period of one year ( p<0.000 ) . Conclusion . The clinical and economic data of the present study suggest that over a follow‐up period of one year the tension‐free vaginal tape procedure is more cost‐effective  than laparoscopic mesh colposuspension as a primary treatment for female stress urinary incontinence Objective To assess the cost effectiveness of tension‐free vaginal tape compared with open Burch colposuspension as a primary treatment for urodynamic stress incontinence OBJECTIVES Stress urinary incontinence affects between 10 percent and 50 percent of women . Surgery is commonly recommended for troublesome incontinence that does not respond to nonsurgical management . Tension-free vaginal tape ( TVT ) is a newer , minimal access surgical sling procedure , which is being increasingly adopted worldwide . The cost-effectiveness of TVT in comparison with other surgical procedures , particularly open colposuspension , is assessed . METHODS Effectiveness estimates came from a systematic review of TVT compared with other surgical procedures ( open and laparoscopic colposuspension , traditional slings , and injectables ) . Deterministic and probabilistic analyses were used to assess the likelihood of  TVT  being cost-effective . Sensitivity analyses assessed the impact of changing assumptions about cure rates and costs for TVT , cure rates for retreatment open colposuspension , and proportions of women who choose retreatment . RESULTS Reliable estimates of relative effectiveness were difficult to derive because the few r and omized controlled comparisons had not been optimally analyzed or fully reported . Results of the economic model suggested that TVT dominates open colposuspension ( lower cost and same quality of life years [ QALYs ] ) within 5 years after surgery . Stochastic analysis indicated that the likelihood of  TVT being cost-effective was 100 percent if decision-makers are unwilling to pay for additional QALYs . TVT 's dominance depended on the assumption fact that retreatment open colposuspension has lower cure rates than a first colposuspension . CONCLUSIONS Analysis based on current short-term data indicates dominance of TVT over open colposuspension from approximately 5 years . There is a need for longer-term follow-up data from method ologically rigorous r and omized trials to provide a sounder basis for estimating the relative benefits and cost implication INTRODUCTION To evaluate the cost-utility of incontinence treatments , particularly anticholinergic therapy , by examining costs and quality -adjusted life years . MATERIAL S AND METHODS A prospect i ve cohort study of women who were consecutively referred by general practitioners ( GPs ) to the Urology Department because of urinary incontinence . The primary outcome was evaluation of the cost-utility of incontinence treatments  ( surgery , medical therapy and physiotherapy ) for stress and /or urgency incontinence by examining costs and quality -adjusted life years . RESULTS 137 consecutive female patients ( mean age 60.6 ± 11.6 ; range 36 - 81 ) were enrolled and stratified according to pathologies : SUI and UUI . Group A : SUI grade II-III : 43 patients who underwent mid-urethral sling ( MUS ) ;  Group B : SUI grade I-II 57 patients who underwent pelvic floor muscle exercise and Group C : UUI : 37 patients who underwent antimuscarinic treatment with 5 mg solifenacin daily . The cost utility ratio ( CUR ) was estimated as saving more than € 1200 per QALY for surgery and physiotherapy and as costing under € 100 per QALY for drug therapy . CONCLUSIONS This study shows that appropriate diagnosis and treatment of a patient with incontinence lowers National Health Service costs and improves the benefits of treatment and quality of life OBJECTIVE To use data from a r and omized controlled trial and up date an earlier economic evaluation of surgery versus collagen injection for the treatment of female stress urinary incontinence ( SUI ) . MATERIAL S AND METHODS A decision tree model was developed using probabilities of success and complications from a r and omized controlled trial . Re source use and cost data were taken from the earlier economic evaluation . The primary outcome was treatment success , which was defined as a negative 24 hour PAD test given 1 year post-treatment . The evaluation was conducted from the ' healthcare system ' perspective and separate analyses were undertaken for Ontario and Québec . Sensitivity analyses were used to examine uncertainty in probabilities and costs . RESULTS Surgery was generally more costly and more successful than collagen injection .  Incremental cost effectiveness ratios indicated that the healthcare system would incur an additional cost of $ 121.08 to $ 341.35 per additional patient that was successfully treated with surgery . Sensitivity analyses showed that surgery would be less costly and more successful than collagen injection if the postoperative length of hospital stay was reduced to 1 day . Surgery might also be more cost effective than collagen injection if the number of injections used to treat patients were to increase beyond two for treatment successes and four for treatment failures . CONCLUSIONS Collagen injection is an outpatient procedure without risk of significant morbidity or complications . However , this does not readily translate into a clear cost effective advantage relative to surgery . In some cases , surgery may be more cost effective than collagen injection in the treatment of female SUI 
    Output:
    
The cost-effectiveness results suggest that single-incision mini-sling and mid-urethral slings are among the most cost-effective options .