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.
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