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December 16, 1998

Improving Treatment of Urinary Incontinence

Author Affiliations

From the Geriatrics Section of General Medicine, Brigham and Women's Hospital, Boston, the Geriatric Research Education and Clinical Center and Division of Urology at the Brockton/West Roxbury Veteran's Affairs Medical Center, West Roxbury, and the Hebrew Rehabilitation Center for Aged and Division on Aging, Harvard Medical School, Boston, Mass.

JAMA. 1998;280(23):2034-2035. doi:10.1001/jama.280.23.2034

More than 15 million persons in the United States have urinary incontinence,1 a condition more prevalent than diabetes mellitus. Urinary incontinence not only causes considerable medical and psychosocial morbidity but it also engenders enormous costs. Conservative projections for costs related to diagnosis and treatment of urinary incontinence exceed $26 billion annually,2 more than is expended by Medicare on dialysis (O. Cohen, oral communication, November 1998) and coronary bypass grafting combined.3 Moreover, these costs apply only to individuals older than 65 years, who constitute less than half of those with urinary incontinence. Unfortunately, most physicians have received little education about incontinence, fail to screen for it, and view the likelihood of successful treatment as low.1 Thus, it is fitting that the study by Burgio et al, which examines the efficacy of biofeedback for urge incontinence, should appear in JAMA.4