Urologic Diseases Research Updates

Report Compiles First-Ever Comprehensive Look at Urologic Disease

Five-Year Effort to be Extended in 2006

Four urologic diseases are responsible for more than 13 million doctors visits a year and more than $6 billion in expenditures, according to the first-ever effort to document the extent and impact of urologic disease in the United States.

The 5-year effort, begun in 2001, is being funded by the National Institute of Diabetes and Digestive and Kidney Disease, or NIDDK. Based on its success, the project is to be continued, with the contract open for recompetition in 2006, ensuring continued compilation and analysis of the data.

The task of gathering data on these conditions is “one of the most important efforts that the NIDDK will undertake at the dawn of the new millennium,” according to the report’s introduction, written by the publication’s editors, Mark Litwin, M.D., M.P.H., and Christopher Saigal, M.D., M.P.H., who are researchers at the University of California-Los Angeles’ Jonsson Comprehensive Cancer Center.

The final version of the Urologic Diseases in America report will eventually quantify the burden of 12 different conditions; the interim version released last fall tackles four: benign prostatic hyperplasia, or enlarged prostate; urinary incontinence; urolithiasis, also known as bladder stones; and urinary tract infection.

Focusing the Discussion
Paul Eggers, M.D., the director of the kidney and urology epidemiology program at NIDDK, said the publication follows similar, successful efforts to define the scope of diabetes and kidney disease. “The urologic communities wanted one of these publications as their own,” he said. “It’s a high-profile kind of thing that people can use. It focuses the discussion into areas of things we don’t know enough about.”

He said that the past efforts in renal disease gave researchers and clinicians “a core amount of knowledge that is not debatable,” a knowledge base that had been lacking in urology.

Billions in Spending
The initial report found that urinary tract infections in adults drive more than 6 million women and 1.4 million men to physicians a year, with a bill for the resulting care of more than $3.5 billion. More than $2 billion is spent annually on urolithiasis, a condition responsible for 600,000 emergency room visits a year. And the 100,000 hospital stays a year for patients with benign prostatic hyperplasia generates a bill of more than $1 billion, not counting money spent on drug therapy.

There had been little available data on the extent of urologic diseases, and what information existed was a “scattered, inconsistent, and not readily available” patchwork of government and private surveys, studies, and information systems, according to the report. The Urologic Diseases in America effort trolled through those sources, then subjected the findings to three layers of expert peer review.

Improving Data
In addition to compiling the data in each of the nine condition-focused chapters of the interim report, the authors of the report also offer suggestions for ways researchers can improve the available data.

The final version of the report, expected next year, will include details on prenatal hydronephrosis, a condition in which urine outflow is blocked; male reproductive health, including erectile dysfunction; urethral disease; interstitial cystitis and chronic prostatitis; prostate cancer; bladder cancer; kidney cancer; and testis cancer.

NIH Publication No. 06–5743
October 2005