High Costs of Urinary Incontinence Among Women Electing Surgery to Treat Stress Incontinence


Introduction: Stress urinary incontinence is associated with substantial economic costs for incontinence management, decrement in health-related quality of life, and a high willingness to pay for incontinence care.

Objectives: 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.

Methods: A total of 655 incontinent women enrolled in the Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr) randomized surgical trial. Baseline out-of-pocket costs for incontinence management were calculated by multiplying the 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 (HUI3). Participants were estimated for their willingness to pay for 100% improvement in incontinence. Potential predictors of these outcomes were examined using multivariable linear regression.

Results: The mean age was 52 years and the mean weekly incontinent episodes was 22 + 21. Mean and median (25%, 75%, interquartile range) estimated personal costs for incontinence management among all women were $14 and $8 ($3, $18) per week, and 617 (94%) women reported any cost. Costs increased significantly with incontinence frequency and mixed vs stress incontinence. The mean and median HUI3 scores were 0.73  and 0.84 (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.

Conclusions: 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 $1400 per year for a cure.

KEYWORDS: (MeSH subjects): urinary incontinence; urinary incontinence - costs; urge incontinence; stress incontinence; urinary incontinence - quality of life; female; multivariate analysis; costs and cost analysis; cross-sectional studies; incontinence pads/*economics; quality of life; severity of illness index; urinary Incontinence/diagnosis/economics/therapy; urinary incontinence, stress/diagnosis/economics/therapy