SACRAL RHIZOTOMIES AND ELECTRICAL BLADDER STIMULATION IN SPINAL-CORD INJURY .2. COST-EFFECTIVENESS AND QUALITY-OF-LIFE ANALYSIS

Objectives: To present a cost-effectiveness analysis of sacral rhizoto mies and electrical bladder stimulation compared with conventional car e of neurogenic bladder dysfunction in patients with spinal cord injur y, Methods: During a 3-year inclusion period, data on costs and qualit y of life before the intervention were collected to describe conventio nal care, Data on the pre-implantation period, the implantation and a follow-up period of 2 years were collected following a strict protocol simultaneous with medical and urodynamic data and were used to calcul ate the costs and effects on quality of life of the implantation of th e stimulator, Results: Between June 1991 and June 1994, 52 patients wi th complete cervical or thoracic spinal cord lesions underwent sacral posterior rhizotomies and implantation of a Finetech-Brindley sacral a nterior root stimulator, Although the initial costs of sacral anterior root stimulation are high, they are earned back in this series in abo ut 8 years after the implantation, General indicators of the quality o f life show no significant changes after the implantation, Factors rel ated to psychological well-being and the patients' satisfaction with t he emptying of the bladder increased significantly whereas the experie nced problems of micturition and incontinence all decreased significan tly, Conclusion: Sacral rhizotomies and electrical bladder stimulation make a cost-effective method of treatment of lower urinary tract dysf unction in patients with spinal cord injury, Considerable savings on h ealth care costs are possible in the long run with simultaneous positi ve effects on aspects of health status.