Urinary incontinence (UI) among women is a growing public health concern in Australia, Japan, and Singapore, particularly among older women and post-surgical patients. Common challenges for UI management with absorbent pads and indwelling urinary catheters include skin-related complications, catheter-associated urinary tract infections (CAUTIs), and fall risk, which increase healthcare workers’ burden and costs. This study examines the burden of female UI across these countries and explores the potential role of novel female external catheters (FECs) in improving outcomes.

A literature search on PubMed, Embase and Ichushi databases identified evidence on female UI burden and FEC effectiveness in the target countries, including studies published up to October 2024. The clinical impact and humanistic burden of FEC were assessed through real-world evidence studies, published quality improvement studies, and patient and caregiver surveys. A cost analysis of FEC implementation in Australia was conducted based on the clinical impact findings with local cost data.

Based on the literature search results, female UI prevalence is high in all three countries, affecting 26% of women in Japan, up to 38% in Australia, and 52% in Singapore. FECs offer notable benefits across clinical, humanistic, and economic dimensions. FECs have been shown to significantly reduce CAUTI rates from 3.14 to 1.42 per 1,000 catheter days, a 54.8% decrease, and have been associated with a low incidence of skin breakdown (5%). 3.6% of hospital admissions involved falls in Australia. UI patients had 3.05 times the fall risks of those without in Japan. The quality of life (QoL) of patients and caregivers is significantly affected by UI, leading to social withdrawal, psychological distress, and sleep disturbances. Burnout among healthcare workers is considered an urgent issue. It has been found that 80% of patients and caregivers report greater satisfaction with FEC use, with 20% noting improved sleep quality due to enhanced comfort and fewer nighttime disturbances. From an economic standpoint, UI-related complications such as CAUTIs, skin complications, and fall-related injuries contribute to more healthcare costs. A cost analysis from the Australian healthcare perspective estimated that FEC implementation could reduce these treatment costs by nearly 50%. As FECs require less frequent changes, it results in an 89% reduction in health workers’ time for managing UI. This translates into annual cost savings of AUD 94,369 per bed, positioning FEC as a cost-saving alternative for UI management.

UI imposes a significant burden with far-reaching clinical, humanistic, and economic consequences. Conventional management leads to complications, underscoring the need for alternatives. FECs provide a non-invasive option to reduce UI-associated complications. Broader adoption of FECs may enhance UI management, improve patient and caregiver QoL, and lower healthcare costs.