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Incontinence Surgery Helps Cut Patient Costs

After having incontinence surgery, women report spending much less money on products and services to manage their symptoms than they did before surgery, a study shows.

Sept. 30, 2010 (Long Beach, Calif.) -- After having incontinence surgery, women report spending much less money on products and services to manage their symptoms than they did before surgery, a study shows.

They save more than $500 a year, researchers found.

The cost savings are not unexpected, says researcher Leslee Subak, MD, a professor at the University of California, San Francisco who presented her findings at the annual meeting of the American Urogynecologic Society in Long Beach, Calif.

"It makes sense," Subak tells WebMD, as women with fewer incontinence episodes don't have to buy products used for symptom management, such as pads, as often. "As your incontinence improves, you spend less money on incontinence care."

Aside from her study, she doesn't think anyone has put a number on the savings everyone suspected would occur. And the number may be higher than anyone thought, she says.

"The amount they saved was $560 per woman, per year," she says, citing the average savings. "I thought that was a lot of money. Incontinence is really expensive."

Incontinence Costs

For the study, Subak and her colleagues polled 491 women, average age 53, who were participating in a study called the Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr).

More than 13 million Americans have urinary incontinence. Stress urinary incontinence, one type, describes a loss of urine that occurs with activities that increase pressure on the abdomen, such as exercising, sneezing, or laughing.

The women in the study reported their out-of-pocket expenses for managing incontinence symptoms -- at the start of the study and then 24 months after surgery.

They reported on costs of supplies such as pads and adult diapers, as well as fees for additional laundry and dry cleaning needed each week due to incontinence episodes.

The more their episodes of incontinence declined, the more their costs declined, says Subak, a professor of obstetrics and gynecology, reproductive sciences, epidemiology, and urology at University of California, San Francisco.

At the study start, women spent an average of about $750 a year. Two years after surgery they spent an average of $190, or $560 less, Subak says. Before incontinence surgery, the average number of incontinence episodes a week was 23, but that declined by 86% two years later, to about three episodes.

Cost savings were similar whether they had Burch or sling surgery, two commonly-used procedures when the study began about seven years ago.

Subak says her patients often tell her, after surgery, "I'm really happy I'm not spending $20 a month on pads." About 37% of the women in the study reported household incomes below $40,000 a year.

"In this country, these items are rarely reimbursed [by insurance plans]," says Subak, referring to hygiene products in addition to laundry and dry cleaning costs.

Second Opinion

The expense of products and services related to incontinence symptoms "is a big issue for patients," says Rebecca Rogers, MD, professor of obstetrics and gynecology and director of the division of urogynecology, University of Mexico Health Sciences Center, Albuquerque, who reviewed the study findings for WebMD. "This [finding about cost savings] verifies something doctors have suspected."

For patients on fixed incomes, she says, managing the costs can be even more difficult. Suppose a patient must choose between buying her blood pressure medication or pads, she says. If the medication wins out, "you can't do anything [socially]."

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