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  1. Long-term cost of fecal incontinence secondary to obstetric injuries. Editorial. Authors'reply.

    Article - En anglais

    INTRODUCTION 

    Anal incontinence is eight times more frequent in females than in males because of injuries sustained at childbirth.

    The aim of the present study was to determine the long-term costs associated with anal incontinence related to obstetric injuries.

    METHODS 

    Sixty-three patients with anal incontinence caused by obstetric sphincter injuries answered questionnaires regarding previous treatments, symptoms, and use of protective products.

    Of the patients, 31 were treated surgically, 11 with biofeedback, 6 with a combination of surgery and biofeedback, and 15 conservatively.

    Treatments and their respective costs were obtained from patient records, patient questionnaires, billing database, and Health Care Financing Administration's 1996 inpatient database.

    Costs were expressed in 1996 dollars.

    RESULTS 

    The mean incontinence score changed from 26 at evaluation to 16 at follow-up (P<0.001).

    The average cost per patient was $17,166

    Evaluation and follow-up charges totaled $65,412, and physiologic assessment accounted for 64 percent of these costs.

    Treatment charges totaled $559,341, and physician charges accounted for 18 percent of these charges.

    CONCLUSIONS 

    Fecal incontinence after childbirth results in substantial economic costs, and treatment is not always successful.

    New treatment modalities, such as artificial bowel sphincter or dynamic graciloplasty, should be assessed to determine their cost-effectiveness.

    Mots-clés Pascal : Accouchement, Complication, Incontinence anale, Sphincter anal, Traitement, Plastie, Sphincter artificiel, Analyse avantage coût, Long terme, Homme, Femelle, Appareil génital femelle, Appareil digestif pathologie, Intestin pathologie, Anorectale pathologie, Chirurgie, Economie santé

    Mots-clés Pascal anglais : Delivery, Complication, Anal incontinence, Anal sphincter, Treatment, Plasty, Artificial sphincter, Cost benefit analysis, Long term, Human, Female, Female genital system, Digestive diseases, Intestinal disease, Anorectal disease, Surgery, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0393919

    Code Inist : 002B13B03. Création : 22/03/2000.