CE Course

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Estimated Healthcare Costs of Incontinence

Urinary incontinence:

$20 billion/year

Fecal incontinence:

$4,000/person/year

Costs for continence management include the costs for adult diapers and other supplies, and impose a significant economic burden to patients as well as the health care system. For women, it was estimated that they spent between $750-900 out of pocket annually for the management of their urinary incontinence (estimated in 2006). The estimated total cost in the U.S. for overactive bladder management was $82.6 billion in 2020. $20 billion of that is the cost for just managing urinary incontinence.

Most of that estimated $20 billion is spent on supplies and management, such as pads and laundry.

Fecal incontinence plays a major role in the current $12 billion market for adult diapers, which is projected to reach $19 billion by 2023. This far surpasses the market for baby diapers.

General population under age 65: 0.5 - 1%

General population over age 65: 3 – 8%

Long-term care residents: 47 – 50%

Overall prevalence

Bowel incontinence affects between 1/2-1% of the general population under the age of 65, and about 3-8% of those over age 65. Sounds like there are bigger health issues to be concerned with, doesn’t it? Well, this next statistic might change your mind. It is estimated that between 47-50% of residents in long-term care suffer from bowel incontinence. That’s a staggering statistic made even more shocking by the fact that much of the bowel and urinary incontinence goes unreported. (WOCN, 2016)

Urinary incontinence: Types and Causes

As we mentioned, urinary incontinence can impact quality of life.

It will be helpful to remember that a loss of bladder control can be an indicator of a deeper problem like weak pelvic floor muscles. This can result in stress incontinence (the leakage of small or large amounts of urine) and is most often related pregnancy and childbirth. Symptoms include the loss of urine during an activity that causes a stress push, such as coughing, sneezing or lifting.

1. Stress

2. Urge (overactive bladder)

3. Mixed: stress + urge incontinence

4. Urine leakage associated with urinary retention (overflow)

5. Functional

6. Reflex

Urge incontinence (which I like to think of as the urge to go “now!”) can be related to the same causes as stress incontinence, including pregnancy and childbirth. Symptoms of urge incontinence include the sudden need to urinate with large volumes of urine.

Mixed incontinence is a combination of stress and urge incontinence. Both stress and urge incontinence are more common in women than in men.

The fourth type of urinary incontinence is leakage related to urinary retention, referred to as ‘overflow incontinence’. The result is a dribble of urine due to inefficient bladder emptying with symptoms similar to stress incontinence.

‘Functional incontinence’ is related to physical and/or cognitive impairments, and can lead to not recognizing the need to urinate in a timely fashion.

And lastly there is ‘reflex or spastic bladder incontinence’, which is related to spinal cord injuries above the 12th thoracic vertebra (T12). This type of problem results in involuntary emptying of the bladder.