Financial toxicity in lower urinary tract symptoms amongst men

Financial toxicity (FT), first reported in oncologic patients and generally defined as harm to patients caused by the cost of treatment, is less well described in non-malignant urology. In chronic conditions related to lower urinary tract symptoms (LUTS), such as BPH, treatment costs may result in a significant substantial burden. The goal of this study was to characterize the association between FT and LUTS. A cross-sectional web-based survey was administered to a random sample of adult men through a national registry of volunteers (ResearchMatch). Disease-specific information, validated symptom scores, and an 11-item measure of LUTS-related financial toxicity were used to characterize participants. Multivariable logistic regression was performed to identify predictors of financial toxicity. A total of 294 respondents with a self-reported history of BPH-associated LUTS were included, 41% of whom met the criteria for financial toxicity. Men with FT had worse LUTS symptom scores across all measures (p < 0.001). The presence of stress, urge, or mixed incontinence was significantly higher in men with FT (52% vs. 8%, 46% vs. 15%, and 36% vs. 5% respectively; p < 0.001). Men with FT spent more out-of-pocket on incontinence products than those without FT (p < 0.001). On multivariable analysis, mixed incontinence was a predictor of FT (OR 3.233, 95% CI 1.15–9.084). Two of five men with LUTS met the criteria for financial toxicity. These men had worse urinary symptom scores, higher rates of all types of incontinence, and higher out-of-pocket costs for incontinence products.