• urinary storage;
  • symptom;
  • cost-of-illness;
  • willingness-to-pay;
  • NHS costs;
  • personal costs


To estimate the cost of clinically significant urinary storage symptoms (CSUSS), including costs borne by the National Health Service (NHS) and individuals, in terms of the use of goods and services in community-dwelling adults.


The subjects were community-dwelling adults aged ≥ 40 years and living in Leicestershire. The prevalence of CSUSS was estimated using a postal questionnaire with a randomly selected sample of 23 182 respondents. The costs associated with CSUSS were estimated using home interviews with 613 cases with and 523 subjects without CSUSS. Cases were defined on the basis of urinary symptoms of leakage, urgency, frequency and nocturia. Willingness-to-pay was used to measure intangible costs as an indicator of the value of alleviating symptoms.


The estimated total annual cost to the NHS for treating CSUSS cases in community-dwelling adults was £536 million at 1999/2000 prices (£303 million and £233 million for men and women, respectively). The total value of costs borne by individuals was estimated to be £207 million (£29 million and £178 million for men and women, respectively). This gives total annual costs related to the use of services of £743 million. There were large intangible costs borne by individuals estimated to be £669 million (£301 and £368 million for men and women) for the UK in terms of willingness-to-pay.


The costs of CSUSS in the community amounted to ≈ 1.1% of overall NHS spending for 1999/2000. Personally borne and intangible costs are also large and important components of the costs of CSUSS. There are large gender differences in the proportion of costs borne by the NHS, i.e. 91% of male and 57% of female costs.