Urinary incontinence (UI) imposes a substantial and often underrecognized financial burden on affected individuals, largely driven by the ongoing need for incontinence management supplies [1]. While UI is highly prevalent among adult women, particularly with advancing age, the economic impact of day-to-day management is frequently overlooked in both clinical care and policy discussions. Prior studies have demonstrated that increasing UI severity is associated with higher overall costs; however, the specific supply categories contributing most significantly to this burden remain poorly characterized. This study aimed to identify the primary cost drivers of UI-related supply use and to examine how utilization patterns vary by UI severity in community-dwelling adult women > 70 years old.

This study represents a secondary analysis of baseline data from the MoVEonUP trial (Mobility and Voiding Exercises in Older Women with Urinary Incontinence), a randomized controlled trial evaluating if a tailored integrated home-based exercise and bladder training intervention (ExerciseUP) reduces falls and improves UI in older women with urgency UI using the validated International Consultation on Incontinence Questionnaire (ICIQ) [2].  Weekly incontinence-related resource utilization was assessed using the Incontinence Resource Use Questionnaire (IRUQ), which captures patient-reported use of incontinence supplies including absorbent products, hygiene materials, and related household resources such as laundry. Descriptions of the disposable incontinence products was derived from the International Continence Society (ICS) report on terminology for single-use absorbent incontinence products [3]. Unit costs for each supply category were derived from publicly available United States (USA) national averages to estimate weekly out-of-pocket expenditures. Descriptive statistics were used to summarize utilization and costs, and differences between severity groups were assessed using Student’s t-test.

Of the 320 participants enrolled in the parent trial (Table 1), 299 (94%) reported using at least one type of incontinence supply and were included in this analysis. Utilization of most supply categories increased with greater UI severity, reflecting a higher reliance on both absorbent products and hygiene-related resources. Use of disposable undergarments was significantly higher among participants with severe or very severe UI compared to those with moderate symptoms (p=0.036) (Table 2). Similarly, laundry frequency, a proxy for additional household burden, was significantly greater in the higher severity group (p=0.002). Disposable bladder control pads, undergarments, adult briefs, and laundry collectively accounted for 83% of total weekly supply-related costs, identifying these as the dominant cost drivers. Overall, participants with more severe UI incurred approximately 1.5-fold higher weekly costs compared to those with moderate UI (USD14.24 vs USD9.35; p<0.001), highlighting a clear gradient between symptom severity and financial burden.

These findings demonstrate that the economic burden of UI is driven by a limited number of high-impact supply categories, particularly absorbent incontinence products and laundry-related costs. In the USA, these expenses are largely borne directly by individuals, as many incontinence supplies are not routinely covered by insurance. As symptom severity increases, reliance on these resources grows substantially, leading to higher out-of-pocket expenditures and compounding financial strain.

Urinary incontinence represents a meaningful and potentially modifiable economic burden, particularly for individuals with more severe symptoms. Strategies to reduce this burden should prioritize improved access to and insurance coverage of key incontinence supplies, as well as interventions that reduce symptom severity and associated resource use. Addressing these gaps may improve both quality of life and financial well-being for affected individuals.

Bishop C., Rodriguez-Cairoli F., Hagens A., Bermudez MA, Van Kerrebroeck P., Collen S. Prevalence, Socioeconomic, and Environmental Costs of Urinary Incontinence in the European Union. Eur Urol. 2025 Aug;88(2):157-166.
Andy U.U., Newman D.K., Wyman J.F., Klusaritz H., Walsh W., Shou H., Koepler N., Schmitz K.H., Reaves S., Arya L., Brown R.T. The Mobility and Voiding Exercises in Older Women with Urinary Incontinence (MoVEonUp) randomized controlled trial: study protocol and rationale. BMC Geriatr. 2024, Dec 4;24(1):994
Fader M, Cottenden A, Chatterton C, et al. An International Continence Society (ICS) report on the terminology for single-use body worn absorbent incontinence products. Neurourology and Urodynamics. 2020;39: 2031–2039. https://doi.org/10.1002/nau.24488