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July 16, 2003

Expanding Treatment Options for Stress Urinary Incontinence in Women

JAMA. 2003;290(3):395-397. doi:10.1001/jama.290.3.395

At least 13 million adults in the United States experience urinary incontinence (UI).1 Most are women, in whom the prevalence of "bothersome incontinence" increases from 2% between the ages of 20 and 24 years to 9% at 50-54 years and to 16% at 85 years.2 The annual direct costs of UI in the United States are estimated at $12.4 billion for women and $3.8 billion for men (in 1995 US dollars),3 similar to estimates for osteoporosis, arthritis, Alzheimer disease, human immunodeficiency virus, and AIDS.1 However, these estimates are conservative because the majority of individuals with UI are unknown to their physician and thus are neither evaluated nor treated. In addition, neither the substantial indirect costs nor the attendant medical or psychosocial morbidity are included in estimates of its impact. Despite these considerations, UI remains relatively neglected by clinicians and researchers alike1 even though this condition is generally responsive to therapy.