Health Care Economic Burden of Treatment and Rehabilitation for Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review

Abstract

Purpose: The clinical, social, and economic impacts of neurogenic lower urinary tract dysfunction (NLUTD) on individuals and health care systems are thought to be immense, yet the true costs of care are unknown. The aims of this study are to illuminate the global costs related to the current state of care for NLUTD. Materials and Methods: A systematic review of the literature was performed using MEDLINE, the National Health Service Economic Evaluation Database, and the Cochrane Specialized Urology and Incontinence Registers. Studies reporting the health care costs of NLUTD were identified. All steps of the review were performed by 2 independent reviewers. Costs were converted to 2022 U.S. dollars and reported for different categories of services. Results: A total of 13 studies were included in the final review (12 from highincome economy, and 1 from an upper-middle-income economy). Routine maintenance care varied notably across studies in terms of included services. Annual supportive costs ranged from $2,039.69 to $12,219.07 with 1 study estimating lifetime costs of $112,774 when complications were considered. There were limited data on the costs of care from the patient's perspective. However, catheters and absorbent aids were estimated to be among the costliest categories of expenditure during routine care. More invasive and reconstructive treatments were associated with significant costs, ranging between $18,057 and $55,873. Conclusions: NLUTD incurs a variety of health care expenditures ranging from incontinence supplies to hospitalizations for management of complications and leads to a significant burden for health care systems over the patient's lifetime. Approaches to NLUTD that focus on functional rehabilitation and restoration, rather than on management of complications, may prove to be a less costly and more effective alternative.

Efficacy of Intravesical Botulinum Toxin A Injection in the Treatment of Refractory Overactive Bladder in Children

“…To compare the effects of intravesical BoNT-A injection in patients with and without relevant neurological disease, we categorized the patients into two groups: neurogenic OAB and non-neurogenic OAB. Neurogenic OAB was defined as OAB that occurred as a result of an injury or disorder of any part of the nervous system including spinal cord injury, spinal dysraphism, or intracranial lesions [15]. Furthermore, we grouped the patients into bladder BoNT-A injection only and bladder plus urethral sphincter BoNT-A injection groups to evaluate the effect of additional urethral sphincter BoNT-A injections on the change in VUDS parameter values.…”

Urodynamics Are Essential to Predict the Risk for Upper Urinary Tract Damage after Acute Spinal Cord Injury

“…The gold standard to assess LUT symptoms, evaluate and monitor LUT function and storage pressures, identify patients with a risk for UUT deterioration, and also to guide and monitor treatment, is video-urodynamic investigation [ 2 , 10 ]. However, urodynamic investigation (UDI) is perceived to have some disadvantages: it is relatively invasive, it requires specialized equipment and expertise, and it is associated with high financial costs [ 11 ].…”

Urinary Dysfunction: Frequency, Risk factors, and Interventions in patients with Cancer during Acute Inpatient Rehabilitation

“…Urge urinary incontinence has been rated as the most bothersome symptom of urinary dysfunction among both women and men [4] and is associated with a substantial economic burden in the United States [5]. Neurogenic lower urinary tract dysfunction has been shown to be a substantial economic burden for healthcare systems worldwide [6].…”