A Comparative Analysis of Surgery and Radiofrequency Therapy for Urinary Incontinence in Iranian Women: Health-Related Quality of Life Improvements and Short-Term Cost-Utility Analyses Publisher



Goudarzi LM ; Darvishi A ; Shams L ; Maher A ; Daroudi R ; Bon SD
Source: Health Technology Assessment in Action Published:2026

Abstract

Introduction: This study evaluated the health-related quality of life (HRQOL) outcomes and the short-term cost-utility of surgery versus radiofrequency (RF) in treating urinary incontinence (UI) among Iranian women. Methods: This prospective non-randomized cohort study with economic evaluation assessed the cost-utility of surgery versus RF from the Iranian health system’s perspective. HRQOL was measured using the EuroQol five-dimensional five-level (EQ-5D-5L) and PRAFAB Urinary Incontinence questionnaires, with data collected from 79 women with UI before and three months after the intervention. Costs were calculated based on hospital records. The final outcome was the quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER) was calculated. Results: The study sample had an average age of 51.43 years. Surgical intervention led to a significant improvement in HRQOL, with a mean utility increase from 0.21 to 0.70 and a decrease in PRAFAB incontinence severity scores. RF treatment also improved HRQOL, with utility increasing from 0.50 to 0.86. Moreover, the mean cost of surgery was USD2,200, significantly higher than that of RF, which was USD 622.52. The ICER for surgery compared to RF was USD12,724.93, indicating that surgery is cost-effective. Conclusion: Surgery and RF both improve HRQOL, with surgery offering a greater QALY gain at a higher cost. Overall, surgery is a cost-effective treatment option compared to RF, supporting its inclusion in treatment guidelines. © 2026 Tehran University of Medical Sciences.