Skip to content

Review: Economic Burden of Non-Cancerous Genitourinary Conditions

Key findings

  • This review examines the economic impact of 14 non-cancerous genitourinary conditions (NCGUC) in U.S. adults
  • In addition, the authors discuss important gaps in the literature, notably the fact that most studies of NCGUC-related costs are based on billing data from administrative datasets and exclude downstream complications and indirect or out-of-pocket costs
  • Some suggestions for improving cost estimates are to use proprietary sources of data, leverage existing national data collection mechanisms, and collect NCGUC data in studies of related conditions such as cardiovascular disease and depression

In October 2019, the National Institutes of Health convened a workshop about the hidden burden of non-cancerous genitourinary conditions (NCGUC). These conditions can be early markers of systemic conditions, including cardiovascular and renal disease. Their economic burden includes substantial indirect costs, such as lost productivity and a higher risk of institutionalization in nursing homes.

Prompted by the workshop, Michelle M. Kim, MD, PhD, director of the Prostate Health Program in the Department of Urology at Massachusetts General Hospital, and colleagues conducted a scoping review to raise awareness of the economic impact of NCGUC and identify knowledge gaps. Their conclusions appear in Urology.


The reviewers searched PubMed for all peer-reviewed journal articles published between 1990 and 2020 that discuss the economic costs of NCGUCs in U.S. adults. The team included aggregate, direct medical, indirect medical, prescription drug, long-term care, and miscellaneous costs.

The conditions included were pelvic organ prolapse, pelvic floor dysfunction, interstitial cystitis, prostatitis, neurogenic bladder, nocturia, urinary tract infections, urolithiasis, urinary incontinence, benign prostatic hyperplasia, overactive bladder, erectile dysfunction, Peyronie's disease, and urethral strictures.

Gaps in the Literature

The authors found 39 articles with relevant cost data, and they report the prevalence and cost burden of the individual conditions.

In general, there were important gaps in the literature because:

  • Some studies refer to treatments that are no longer widely used
  • The literature has yet to reflect that the prevalence and costs of many NCGUC conditions are increasing because of the aging of the U.S. population
  • Most studies rely on billing data from administrative datasets, in which downstream complications are difficult or impossible to ascertain, and indirect or out-of-pocket costs incurred by people with NCGUC, caregivers, or family members are excluded
  • Cost studies are often driven by companies introducing new drugs or devices, which leaves many conditions neglected

Improving Cost Estimates

The authors offer several suggestions for gaining access to needed data:

  • Engage better with proprietary sources of data such as insurance companies, healthcare systems, and device/product manufacturers
  • Leverage existing data collection mechanisms; for example, the Research and Development Survey (RANDS) of the National Center for Health Statistics was recently modified to include a question about time lost from work due to COVID-19
  • Studies on conditions associated with NCGUC, such as falls/fractures, cardiovascular disease, and depression, could collect NCGUC data for a better understanding of the connections among these conditions with regard to costs

Learn about the Prostate Health Program

Refer a patient to the Department of Urology

Related topics


By analyzing a nationally representative sample of U.S. women, Michelle M. Kim, MD, PhD, and colleagues determined moderate physical activity is associated with a decreased likelihood of stress, urge and mixed urinary incontinence.


Jason Lee, MD, Brian H. Eisner, MD, and colleagues found the quick Sequential Organ Failure Assessment (qSOFA) may demonstrate false-positive results in predicting septic shock among patients with diabetes who have ureteral stones and concomitant infection, and diabetes was not an overall risk factor for septic shock.