Abstract
OBJECTIVE
To describe the health characteristics and current treatment choices of male stress
urinary incontinence (mSUI) patients to inform patient-centered decision-making.
METHODS
We identified a cohort of mSUI patients aged ≥65 at UCSF and San Francisco VA. Using
retrospective chart review and telephone interviews, we ascertained demographics,
incontinence characteristics, Charlson Comorbidity Index (score ≥ 4 indicates significant
morbidity), frailty with Timed Up and Go (TUG) test, functional dependence with activities
of daily living (ADL), calculated life expectancy, and assessed mental health and
quality of life (QOL). Bivariate analysis evaluated associations between subject characteristics
and ultimate treatment type (conservative vs surgery; sling vs sphincter). Logistic
multivariable models evaluating treatment choice were also constructed.
RESULTS
The 130 participants had a mean age of 75 and a mean incontinence score of 14.2 representing
moderately bothersome incontinence. Nearly 80% had significant morbidity, three-quarters
had >50% 10-year mortality risk, 10% needed help with 1 + ADL and 22% had a TUG >10
seconds indicating frailty. The mean physical and mental QOL scores were similar to
the general population. Anxiety and depression were reported by 3.9% and 10%. In univariate
and multivariable analysis, only incontinence characteristics were associated with
conservative vs surgical treatment choice (P < .01).
CONCLUSION
Multi-morbidity, functional dependence, frailty, and limited life expectancy are common
among older men with mSUI, yet current treatment choices appear to be driven by incontinence
characteristics. As such, mSUI surgery should be considered among men across the spectrum
of health and life expectancy.
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Article info
Publication history
Published online: May 15, 2021
Accepted:
May 3,
2021
Received:
March 20,
2021
Footnotes
Funding: National Institute of Aging GEMSSTAR 1R03AG064372-01 (PI: Hampson); Doris Duke Charitable Foundation CTSI – UL1 TR001872 (PI: Hampson); Claude D. Pepper Older Americans Independence Center UCSF Research Education Component Scholar Award (PI: Hampson); San Francisco Veterans Affairs Medical Center (Hampson, Cooperberg, Sudore, Keyhani, Walter).
Identification
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