Purpose: Data regarding health state utilities for urge urinary incontinence (UUI) are very limited. We sought to assess patient preferences for different severities of and treatment options for UUI using ELICIT, a computer elicitation tool we recently developed.
Methods: We assessed utilities for 3 severity levels of UUI (mild, moderate and severe), as well as 3 different UUI treatments without and with adverse events (AE). These treatments included 1) anticholinergic medications without AE or with dry mouth and constipation, 2) botulinum toxin injection into the bladder without AE or with urinary retention, and 3) sacral neuromodulation (SNS = implantation of a pacemaker like device that stimulates the sacral nerves) without AE or with persistent irritation in the leg, foot or vagina. Preferences were assessed using the visual analog scale (VAS) and time trade-off techniques (TTO), which were interviewer-administered using ELICIT, a computer program that we developed. Subjects also completed a demographics and medical history questionnaire. Our goal was to measure preferences in 40 women with UUI symptoms and 40 women without these symptoms. In this abstract, we present data on the first 40 women with UUI.
Results: For these 40 subjects, the mean age was 59.2±13.8 (range 25-86), 85.0% were white, 77.5% were married and 17.5% had a college degree. Median TTO utilities for UUI decreased as severity increased (Table 1). As expected, median VAS scores were lower than TTO scores. Median TTO utilities for anticholinergic medications were higher than those for botulinum and SNS, and adverse events lowered the utilities for each treatment (Table 2).
Conclusion: Urge urinary incontinence has a significant impact on health-related quality of life, especially for women with moderate or severe symptoms. The degree of invasiveness and potential adverse events are important considerations for patient preferences regarding treatment options for urge incontinence. Table 1. Utility scores for different severities of urge urinary incontinence (UUI).
Mild UUI | Moderate UUI | Severe UUI | |
| Median TTO | 0.86 | 0.79 | 0.73 |
| Median VAS | 0.79 | 0.62 | 0.43 |
Meds, no AE | Meds, AE | Botulinum, no AE | Botulinum, AE | SNS, no AE | SNS, AE | |
| Median TTO | 0.94 | 0.88 | 0.83 | 0.73 | 0.83 | 0.79 |
| Median VAS | 0.82 | 0.70 | 0.67 | 0.33 | 0.71 | 0.41 |
Candidate for the Lee B. Lusted Student Prize Competition