Experts discuss asking about leakage and talking about incontinence treatment options for men

Opinion
Video

"Ask about leakage and talk about options," says Lindsay A. Hampson, MD, MAS.

In this video, Nathan M. Shaw, MD, and Lindsay A. Hampson, MD, MAS, share the take-home messages from the Neurourology and Urodynamics study, “How older men live with stress urinary incontinence: Patient experience and navigation to treatment.” Shaw is an assistant professor of urology and an assistant professor of plastic and reconstructive surgery at Medstar Georgetown University Hospital in Washington, DC. Hampson is an associate professor of urology associate chair of education and Residency Program Director at the University of California, San Francisco.

Transcription:

What is the take-home message from this study?

Shaw: I think the take-home message of this paper, put simply, is that you need to ask these patients about their incontinence, and not to just simply ask how many pads they're going through, or what they're doing to manage or mitigate their incontinence, but [ask] if they want to change from where they are, because I think the patient who leaks 1 pad a day does often get dismissed as, "Oh, that's not too bad, that's mild." But there's very good evidence from our group and others that incontinence is personal, and that even 1 pad a day can really limit the quality of life, depending on what that patient's lifestyle looks like. So absolutely ask these patients if they're experiencing bothersome symptoms, and then get them to the right people, and that there are absolutely treatment options available.

Hampson: I think along with that, I would just say that explaining what those treatment options look like, as we've already talked about, is so important. Because some people will first say, well, they're not bothered by it. But once they understand what treatment options look like, they may actually decide that it's bothering them enough to pursue treatment. It's really about asking about leakage. But also knowing that, even if they don't have leakage right now, or they don't have bothersome leakage right now, or they're not sure if it's bothersome, it's still worth it to counsel them about treatment options. There's an important study published by another group that shows that the majority of men with incontinence want treatment, even though they're not telling people or their providers about it. And we found the same true in our own data. We found that even though many men kept this private, not telling their family members, not taught telling their physicians, their surgeons, many of them, in fact, the vast majority of those individuals ended up pursuing treatment. So even if people aren't talking about it, or asking about it, or say they're bothered by it, it's still worth it to explain what the treatment options look like. That could mean referring them to somebody who is a specialist in incontinence, or it could mean the urologist who's treating them for their prostate cancer telling them about those options and giving an option to meet with somebody else. Ask about leakage and talk about options.

This transcription was edited for clarity.

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