The impact of urologic diseases on the American public

Urologic conditions like urinary tract infections, kidney stones, and prostate cancer are a major economic burden on Americans, resulting in health care costs of close to $40 billion annually, according to a newly released national report that charts the demographic and economic impact of urologic diseases in the U.S. Urologic Diseases in America (UDA), last published in 2007, has been revised and updated for 2012 and includes a wealth of new, detailed information on the utilization of resources and the costs associated with urologic diseases among men, women and children. The information is organized in tables and designed for use by academic and public health researchers, clinicians, and government officials who are studying these conditions. Researchers from UCLA, the National Institutes of Health's National Institute of Diabetes and Digestive and Kidney Diseases and RAND Health teamed to develop UDA and the 500-page update. The new edition includes the latest urologic information available and was expanded to include more pediatric conditions. "Few other medical fields have a dedicated source of extensive utilization and cost information that is easily accessible," said UDA's editor and co-principal investigator, Dr. Christopher S. Saigal, an associate professor in the department of urology at the David Geffen School of Medicine at UCLA and a researcher with UCLA's Jonsson Comprehensive Cancer Center. UDA has proven to be an invaluable source of data. The project and its collaborators, which include researchers from across the country, have analyzed UDA data and published more than 70 papers in academic journals, providing key insights into the prevalence, treatment patterns, costs and overall impact of urologic conditions. Here are a few examples: In a UDA study published in the March 2012 edition of the journal Cancer, researchers found that nearly all patients with high-grade, non-invasive bladder cancer are not receiving the guideline-recommended care that would best protect them from disease recurrence. A study published in the July 2011 edition of the journal Urology found that clinical guidelines for benign prostatic hyperplasia, a condition involving enlargement of the prostate that affects more than half of men in their 60s, were only followed to a moderate degree and that great variations in care existed from region to region in the U.S. A March 2011 study in the Journal of Urology showed that a treatment for urinary urge incontinence in which electrical stimulation is applied to the sacral nerve through an implanted device was less acceptable to the general public than expected from clinical trials. Only 24 percent of patients underwent a "basic" trial run of the device, and only 51 percent of those who underwent an "advanced" evaluation of the device chose to receive a permanent device. In conducting further research, scientists can now work with an interactive version of the report on the UDA website that allows them to produce their own personalized tables and graphs, helping them customize and accelerate their research findings. "We hope the new edition of UDA will continue to help academic and clinical communities better understand the impact of these conditions and inspire us to continue to confront new problems and ideas," said Dr. Mark S. Litwin, professor and chair of the urology department at the Geffen School of Medicine and a researcher with the Jonsson Comprehensive Cancer Center. The new edition of UDA is the first full update since 2007 and includes data gathered between 2002 and 2007. The original report included data from 1992 to 2001.