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 US dollars and reported for different categories of services.
Results
A total of 13 studies were included in the final review (12 from high-income 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 2,039.69to 12,219.07 with 1 study estimating lifetime costs of 112,774whencomplicationswereconsidered.Therewerelimiteddataonthecostsofcarefromthepatient’sperspective.However,cathetersandabsorbentaidswereestimatedtobeamongthecostliestcategoriesofexpenditureduringroutinecare.Moreinvasiveandreconstructivetreatmentswereassociatedwithsignificantcosts,rangingbetween 18,057 and 55,873.
Conclusions
NLUTDincursavarietyofhealthcareexpendituresrangingfromincontinencesuppliestohospitalizationsformanagementofcomplicationsandleadstoasignificantburdenforhealthcaresystemsoverthepatient’slifetime.ApproachestoNLUTDthatfocusonfunctionalrehabilitationandrestoration,ratherthanonmanagementofcomplications,mayprovetobealesscostlyandmoreeffectivealternative.