Economic Burden of Urgency Urinary Incontinence in the United States: A Systematic Review

Abstract

BACKGROUND: The International Continence Society (ICS) identifies several urinary incontinence (UI) subtypes: urgency urinary incontinence (UUI), stress UI (SUI), and mixed UI (MUI). UUI is a common symptom of overactive bladder (OAB) syndrome. Based on the current ICS definition of OAB, all patients with UUI have OAB, whereas not all patients with OAB have UUI. Because UUI is a chronic condition that is expected to increase in prevalence as the population of elderly individuals grows, it is important to understand its economic burden on society and patients and its cost components.OBJECTIVE: To summarize the published English language medical literature on estimates of the economic burden of UUI in the United States from a societal and patient perspective, including direct costs (diagnosis, treatment, routine care [including incontinence pads], and UUI-associated comorbidities/complications); indirect costs (lost wages by patients and caregivers and lost work productivity due to absenteeism and presenteeism); and intangible costs (pain, suffering, and decreased health-related quality of life).METHODS: A PubMed search of the literature for articles on the economic burden of UUI in the United States was conducted using the search terms (urgency urinary incontinence OR urge incontinence OR mixed incontinence OR overactive bladder) AND (burden OR cost OR economic) AND (United States), with limits for English language, publication from 1991 to 2011, humans, and adults (19+ years). Only primary articles of non-neurogenic UUI in the United States were retained.RESULTS: Seven studies were identified that included data on the economic burden of UUI in the United States from a societal and patient perspective. Although estimates of the total economic burden of UUI include direct, indirect, and intangible costs, none of the 7 U.S. studies included all of these cost components. Furthermore, the costs of UUI often could not be fully extracted from the costs of OAB, which include patients with and without UUI, or the costs of other types of UI. The most recent cost analysis incorporated OAB with UUI prevalence rates and data on use of each cost component to calculate the total annual direct costs in 2007 for adults aged ≥ 25 years. The estimated total national cost of OAB with UUI in 2007 was $65.9 billion, with projected costs of $76.2 billion in 2015 and $82.6 billion in 2020. This 2007 estimate was markedly higher than those reported in older studies. Direct costs are the main driver of the overall cost of UUI in the United States. Studies that assessed patient costs indicated that the personal costs of routine care items for UUI and MUI represent a meaningful contribution to the overall economic burden of these conditions. These substantial personal expenditures may explain why patients reported that they were willing to pay considerable amounts for a treatment that would reduce the frequency of their UUI episodes.CONCLUSIONS: UUI in the United States is associated with a substantial economic burden from both a ...

Bladder Symptoms in the Early Menopausal Transition

“…1,2 Bladder symptoms, such as incontinence, urgency, or frequency, are commonly associated with a lower quality of life and increased use of healthcare resources. [3][4][5][6][7] Bladder symptoms may be due to age-related autonomic denervation, decreased bladder muscle tone, or increased bladder muscle fatigue. 8 Parity and medical conditions, such as diabetes, obesity, and depression, are associated with prevalence and incidence of bladder symptoms.…”

Prevalence and knowledge of urinary incontinence and possibilities of treatment among low-income working women

“…Defined as any involuntary loss of urine (1), Urinary Incontinence (UI) is a frequent condition, with an estimated prevalence of 52.3% in Brazilian women (2) and having projected costs amounting to US $ 82.6 billion in 2020 in the United States (3). The UI symptoms lead to different problems such as psychological changes and disturbances in personal, sexual, social and professional relationships, negatively influencing the quality of life of this population (4).…”

Effectiveness of an illustrated home exercise guide on promoting urinary continence during pregnancy: a pragmatic randomized clinical trial

“…Além disso, intervenções cirúrgicas e medicamentosas geram altos custos para os sistemas de saúde e acabam se tornando pouco plausíveis no que tange ao circuito custo-eficácia--efetividade. Estudos realizados nos Estados Unidos sobre o custo do tratamento da IU apresentam montantes que variam, devido ao uso de diferentes definições de IU e dos diferentes métodos de análise utilizados, entre 16 e 65 bilhões de dólares anuais 2,9 . Assim, atualmente, a ICS aponta a reabilitação do assoalho pélvico (AP) como sendo a primeira opção de tratamento da IU 8 , uma vez que os exercícios perineais são de baixo custo e risco, não invasivos, combatem a diminuição da FMAP e, desse modo, são capazes de prevenir, diminuir ou curar a IU, além de promover o bem-estar [10][11][12] .…”