Investigators evaluate men’s experience with stress urinary incontinence

Opinion
Video

“The main rationale for this research was we felt like there was an unaddressed population of patients living with urinary incontinence,” says Nathan M. Shaw, MD.

In this video, Nathan M. Shaw, MD, and Lindsay A. Hampson, MD, MAS, share the background behind 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:

Please discuss the background for this study.

Shaw: The main rationale for this research was we felt like there was an unaddressed population of patients living with urinary incontinence. Specifically, when we're talking about this, we're talking about men who are living with urinary incontinence after prostate cancer or prostate therapy. And we felt like we know that there's a lot of men who suffer from incontinence after prostate cancer therapy. That number varies depending on the literature that you look at. But in general, probably up to a third or more of men will have some degree of incontinence following prostate cancer surgery, and only a very small number, certainly in the single digits, probably less than 5% of those men will eventually pursue any sort of surgical management options for their incontinence. So our thinking there is this disconnect between the number of men that are living with this incontinence, which we know can be very bothersome, and the number of men who are getting surgical treatment. Our question was, is this a matter of patients are being offered this treatment and simply not pursuing it? Or potentially not being offered this treatment? That second piece is very difficult to answer, as you might imagine. How do you find the patients that aren't being offered something? Our main goal was to really understand the patients who at least get to the stage where they're being offered therapy, and begin to understand the decision-making frame that they're in, and some of the things that are important to those men.

Hampson: And I think the other thing that I would add is that the experience that these men have in living with incontinence is really poorly characterized in the literature. We have quantitative data around how many pads people use and how many people have leakage, but we don't really understand what the true impacts are to quality of life. And one real big benefit of doing qualitative research and interviewing men is to actually be able to assess the impacts on somebody's life. I don't think you can get those sorts of takeaways and stories from anything else. And so we felt it was very necessary and powerful to actually get the patient voice. One of the big goals of our research, apart from everything that Dr. Shaw just explained, was really just to go to patients and hear their stories and hear it in their own words, and learn from their own experiences, what are the challenges, the hurdles, the obstacles that they faced?

This transcription was edited for clarity.

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