MP56-02 DECISIONAL REGRET AFTER STRESS URINARY INCONTINENCE TREATMENT AMONG OLDER MALES

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) III (MP56)1 Sep 2021MP56-02 DECISIONAL REGRET AFTER STRESS URINARY INCONTINENCE TREATMENT AMONG OLDER MALES Lindsay Hampson, Anne Suskind, Benjamin Breyer, Matthew Cooperberg, Rebecca Sudore, Salomeh Keyhani, Isabel Allen, and Louise Walter Lindsay HampsonLindsay Hampson More articles by this author , Anne SuskindAnne Suskind More articles by this author , Benjamin BreyerBenjamin Breyer More articles by this author , Matthew CooperbergMatthew Cooperberg More articles by this author , Rebecca SudoreRebecca Sudore More articles by this author , Salomeh KeyhaniSalomeh Keyhani More articles by this author , Isabel AllenIsabel Allen More articles by this author , and Louise WalterLouise Walter More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002086.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: When seeking treatment for male SUI (mSUI), patients are faced with weighing complex risks and benefits in making treatment decisions within their individual context. To move towards improved decision-making, we aimed to quantify the frequency of decisional regret among this patient population and to determine factors associated with regret. METHODS: We identified males aged ≥65 seen at the University of California, San Francisco Medical Center and the San Francisco Veterans Affairs Medical Center for initial mSUI consultation from June 2015 – March 2020. Using retrospective chart review and telephone interviews, we ascertained decisional regret (validated 0 to 100 scale, with >25 = moderate to severe regret). Decisional regret was analyzed by treatment type and patient-, disease-, and treatment-related factors. A multivariable logistic regression model was built to examine the factors most associated with decisional regret. RESULTS: Among the cohort, the mean decisional regret score was 14.0 ± 23.1, with 29 individuals (22%) having moderate to severe regret. In bivariate analysis, decisional regret was higher in those with depression and lower in those with higher mental QOL scores, higher shared decision-making scores, and higher post-treatment leakage scores (Table). In terms of treatment, regret was highest among those electing conservative management, with 83% having decisional regret (vs. with treatment: 3% sling, 14% sphincter, p < 0.001). In multivariable analysis, depression (OR 14.1; 1.7,120.3), shared decision-making (OR 0.98; 0.96,0.99), and incontinence score (OR 1.81; 1.0,2.6) were significantly associated with decisional regret. CONCLUSIONS: One fifth of males presenting with mSUI report decisional regret. Depression and higher incontinence scores are associated with more regret, while shared decision-making is associated with less. Recognition of depression, improved efforts at shared decision-making, and more individualized treatment counseling have the potential to improve patient satisfaction with treatment choice. In addition, given high levels of regret among those electing conservative treatment, we may be underutilizing mSUI surgery in this population. Source of Funding: NIA, Department of Veterans Affairs, Claude D. Pepper Older Americans Independence Center, Doris Duke Charitable Foundation © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e969-e970 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lindsay Hampson More articles by this author Anne Suskind More articles by this author Benjamin Breyer More articles by this author Matthew Cooperberg More articles by this author Rebecca Sudore More articles by this author Salomeh Keyhani More articles by this author Isabel Allen More articles by this author Louise Walter More articles by this author Expand All Advertisement Loading ...