Departments of Obstetrics, Gynecology & Reproductive Sciences and Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California.

Departments of Obstetrics & Gynecology and Urology, Loyola University, Chicago, Illinois; Department of Urology, University of Maryland, Baltimore, Maryland; Department of Urology, William Beaumont Hospital, Royal Oak, Michigan; Geriatric Research, Education and Clinical Center, Birmingham Veterans Affairs Medical Center, and University of Alabama at Birmingham, Birmingham, Alabama; Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas; National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland; Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Reproductive Medicine, University of California, San Diego, San Diego, California; Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah; and New England Research Institutes, Watertown, Massachusetts.

To estimate costs for incontinence management, health-related quality of life, and willingness to pay for incontinence improvement in women electing surgery for stress urinary incontinence.

A total of 655 incontinent women enrolled in the Stress Incontinence Surgical Treatment Efficacy Trial, a randomized surgical trial. Baseline out-of-pocket costs for incontinence management were calculated by multiplying self-report of resources used (supplies, laundry, dry cleaning) by national resource costs ($2006). Health-related quality of life was estimated with the Health Utilities Index Mark 3. Participants estimated willingness to pay for 100% improvement in incontinence. Potential predictors of these outcomes were examined by using multivariable linear regression.

Mean age was 52+/-10 years, and mean number of weekly incontinence episodes was 22+/-21. Mean and median (25%, 75% interquartile range) estimated personal costs for incontinence management among all women were $14+/-$24 and $8 (interquartile range $3, $18) per week, and 617 (94%) women reported any cost. Costs increased significantly with incontinence frequency and mixed compared with stress incontinence. The mean and median Health Utilities Index Mark 3 scores were 0.73+/-0.25 and 0.84 (interquartile range 0.63, 0.92). Women were willing to pay a mean of $118+/-$132 per month for complete resolution of incontinence, and willingness to pay increased significantly with greater expected incontinence improvement, household income, and incontinent episode frequency.

Urinary incontinence is associated with substantial costs. Women spent nearly $750 per year out of pocket for incontinence management, had a significant decrement in quality of life, and were willing to pay nearly $1,400 per year for cure.

Written by
Subak LL, Brubaker L, Chai TC, Creasman JM, Diokno AC, Goode PS, Kraus SR, Kusek JW, Leng WW, Lukacz ES, Norton P, Tennstedt S.

Reference
Obstet Gynecol. 2008 Apr;111(4):899-907.

PubMed Abstract
PMID:18378749

UroToday.com Stress Urinary Incontinence Section

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