Urologists Self-Report Rates of Postprostatectomy Incontinence and Referral Patterns for Treatment.

Area of Science:

• Urology
• Surgical Outcomes
• Patient Management

Background:

• Postprostatectomy incontinence (PPI) rates after radical prostatectomy (RP) vary significantly.
• Current management strategies for PPI are influenced by surgeon perception, with limited data on their self-perceived PPI rates.

Purpose of the Study:

• To investigate the perceptions and practice patterns of radical prostatectomy (RP) surgeons regarding postprostatectomy incontinence (PPI).
• To understand how surgeons perceive their own PPI rates and their referral habits for managing bothersome PPI.

Main Methods:

• A 22-question survey was developed to assess RP surgeon perceptions, demographics, practice patterns, and outcomes.
• The survey was disseminated through various channels including social media and alumni mailing lists, gathering 93 responses.

Main Results:

• Most surgeons (74%) do not perform anti-incontinence procedures and refer less than 6% of patients for surgical evaluation.
• A majority (62%) refer at least 50% of patients with bothersome PPI to pelvic floor physical therapy (PFPT).
• Higher perceived PPI rates correlated with lower referral rates to other urologists and PFPT.

Conclusions:

• RP surgeons may contribute to the undertreatment of PPI by underestimating their own rates compared to published literature.
• Most RP surgeons do not perform PPI procedures and have low referral rates for both surgical evaluation and PFPT.
• Addressing undertreatment requires surgeon education, standardized reporting, and improved access to specialized surgeons and PFPT.