PURPOSE: To compare the cost-effectiveness of various treatment strategies in the management of pelvic fracture @entity130 using decision analysis. METHODS: Five strategies were modeled from the time of @entity130 voiding or progression to urethroplasty. Management consisted of immediate suprapubic tube (SPT) placement and delayed urethroplasty; @entity298 ( @entity298 ) followed by urethroplasty in failed @entity1 ; or @entity298 followed by 1-3 direct vision internal urethrotomies (DVIU), followed by urethroplasty. Success rates were obtained from the literature. Total medical costs were estimated and incremental cost-effectiveness ratios (ICERs) were generated over a 2-year follow-up period. RESULTS: @entity298 was preferred over SPT placement in all iterations of the model. @entity298 followed by a single DVIU and urethroplasty in cases of failure was least costly and used as the referent approach with an average cost-effectiveness of  17,493 per unobstructed voider. The @entity10679 of a second DVIU prior to urethroplasty was  86,280 per unobstructed voider, while the @entity10679 of a third DVIU was  172,205. The model was sensitive to changes in the success rate of the first DVIU, where when the probability of DVIU success is expected to be less than 32% immediate urethroplasty after failed @entity298 is favored. CONCLUSIONS: Management of pelvic fracture @entity130 with @entity298 is the preferred management strategy according to the current model. For those who fail @entity298 , a single DVIU may be attempted if the presumed success rate is >32%. In all other cases, urethroplasty following @entity298 is the preferred approach.

Cost-effective management of pelvic fracture XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity10679 :: ('1390', 'Gene') :: ['ICER'] @entity298 :: ('MESH:D010538', 'Disease') :: ['primary endoscopic realignment', 'PER'] @entity130 :: ('MESH:D014947', 'Disease') :: ['injury to resolution of obstructed', 'urethral injuries']
@entity130 :: (MESH:D014947,Disease) :: ['urethral injuries']
