What Data Do We Need to Show the Cost and Clinical Effectiveness, Bearing in Mind Sustainability, of Urological Disposables in Different Patient Groups? Ici-rs 2025

INTRODUCTION: Urological disposables, including catheters, stents, irrigation systems, and incontinence pads, are essential in functional urology but generate large volumes of nonbiodegradable waste. Intermittent self-catheterization is the gold standard for impaired bladder emptying, while disposable pads are a frequent first-line coping strategy for incontinence. Their widespread use presents a growing environmental challenge in healthcare.

METHODS: At the 2025 International Consultation on Incontinence-Research Society meeting, a dedicated session examined sustainability in urological disposables. Three questions were addressed: (1) how to define and measure sustainability, (2) whether sustainable alternatives are clinically effective and safe compared to conventional products, and for which patient groups, and (3) whether disposables are cost-effective when environmental and health system costs are included.

RESULTS: Sustainability assessment involves life cycle analysis, carbon and water footprint evaluation, material composition, and waste generation. Existing sustainability studies are limited, non-comparative, and methodologically inconsistent, often using variable definitions and incomplete life cycle boundaries. Reusable incontinence pads and catheters generally have a lower environmental impact than single-use designs. Clinical outcomes, including infection rates and safety, are largely comparable between reusable and single-use catheters, though user preference often favors single-use products for convenience. Economic evaluations rarely incorporate environmental impacts, but proposed methods include monetizing emissions, converting environmental effects into health outcomes, and applying multi-criteria decision-making to integrate sustainability alongside clinical and economic performance.

CONCLUSION: Advancing sustainable continence care requires standardised metrics, integration of environmental costs into economic evaluations, and patient-centered product innovation, supported by collaboration between clinicians, policymakers, and industry.