High costs of urinary incontinence among women electing surgery to treat stress incontinence.
OBJECTIVE
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, 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 (USD2,006). 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.


RESULTS
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 USD14+/-USD24 and USD8 (interquartile range USD3, USD18) 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 USD118+/-USD132 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 USD750 per year out of pocket for incontinence management, had a significant decrement in quality of life, and were willing to pay nearly USD1,400 per year for cure.
Subak
Leslee L
LL
Department of Obstetrics, Gynecology & Reproductive Sciences and Epidemiology & Biostatistics, University of California, San Francisco, California, USA. subakl@obgyn.ucsf.edu
Brubaker
Linda
L
Chai
Toby C
TC
Creasman
Jennifer M
JM
Diokno
Ananias C
AC
Goode
Patricia S
PS
Kraus
Stephen R
SR
Kusek
John W
JW
Leng
Wendy W
WW
Lukacz
Emily S
ES
Norton
Peggy
P
Tennstedt
Sharon
S
D000328:Adult; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D017558:Elective Surgical Procedures / Q000191:economics; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D025341:Principal Component Analysis; D011788:Quality of Life; D014481:United States; D014550:Urinary Incontinence, Stress / Q000191:economics* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000191:economics