Knowledge Gaps and Barriers to Care in Men with Postprostatectomy Incontinence: Evidence from the German ProKontinenz...

Area of Science:

• Urology
• Surgical Oncology
• Patient Quality of Life

Background:

• Postprostatectomy incontinence (PPI) significantly impacts quality of life for many men.
• Despite effective surgical interventions, PPI remains undertreated, indicating a potential care gap in Europe.
• This study investigates patient awareness and barriers concerning surgical treatments for PPI.

Purpose of the Study:

• To assess the level of knowledge regarding surgical treatment options for persistent postprostatectomy incontinence (PPI).
• To identify barriers preventing patients from seeking or undergoing surgical treatment for PPI.
• To explore the association between symptom burden, quality of life, and knowledge of surgical interventions.

Main Methods:

• A cross-sectional analysis of the ProKontinenz trial involving men with persistent PPI for over 12 months post-radical prostatectomy.
• Validated questionnaires and a 24-hour pad test were used to collect data on patient knowledge, information sources, and treatment barriers.
• Logistic regression analysis was employed to identify predictors associated with a lack of knowledge about surgical PPI treatments.

Main Results:

• Fifty-nine percent of participants reported no knowledge of surgical treatments for PPI.
• Key barriers to considering surgery included satisfaction with incontinence products (79%), concerns about surgical risks (53%), and doubts about surgical success (51%).
• Lack of knowledge was independently associated with lower symptom severity, concerns about treatment success, and insufficient information from urologists.

Conclusions:

• A significant proportion of men with persistent PPI are unaware of potentially effective surgical treatment options.
• Information deficits and symptom perception play a crucial role in treatment knowledge and uptake.
• Enhancing guideline-based information dissemination and improving clinician-patient communication are essential to address this knowledge gap and improve PPI management.