BACKGROUND

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.

METHODS

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.

RESULTS

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 ( < 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;  < 0.001). Men with FT spent more out-of-pocket on incontinence products than those without FT ( < 0.001). On multivariable analysis, mixed incontinence was a predictor of FT (OR 3.233, 95% CI 1.15–9.084).

CONCLUSION

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.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12894-025-01895-4.