Authors
Viktoria Menzel, Christoph Kowalski, Sophie Klara Schellack, Rainer Koch, Sebastian Dieng, Axel Haferkamp, Alexander Winter, Andreas Blana, Carsten Schwarzer, Andreas Gonsior, Karl H Tully, Stefan Baltes, Ingo Kausch, Andreas Manseck, Serdar Deger, Firas Jamour, Jörg Erdmann, Ina H Kunz, Holger Kujau, Martina Schleder, Anna Schulze, Jan Ramm, Markus Straub, Jasper Koenig, Dennis Wielander, Andreas Neisius, Hans-Peter Gerbershagen, Felix Wezel, Stefan Conrad, Reinhard Hofmann, Simon Müller, Karl-Dietrich Sievert, Rishav Pradhan, Roger Riexinger, Petra Stamm, Thomas Knoll, Oliver Hahn, Johannes Graff, Ernst-Günther Carl, Johannes Huber, Christian Thomas, Martin Baunacke
Published in
European urology open science. Volume 90. Pages 33-41. Epub Jun 22, 2026.
Abstract
Postprostatectomy incontinence (PPI) reduces quality of life, yet remains undertreated despite effective surgical options. Persistently low intervention rates in Europe for PPI suggest a care gap. This study assessed patients' knowledge of surgical PPI treatments and barriers to treatment uptake.
Cross-sectional baseline analysis of ProKontinenz trial. Men with persistent PPI for ≥12 mo after radical prostatectomy (≥2 pads/d, no prior incontinence surgery) from 34 certified prostate cancer centers were surveyed during January-June 2025, using validated questionnaires and 24-h pad test. The primary outcome was knowledge of incontinence surgery; secondary outcomes included information sources, treatment barriers, and associations with symptom burden/quality of life. Associations with knowledge were assessed using logistic regression.
A total of 526 of 692 men participated (90% response rate). Among the participants, common reasons for not considering incontinence surgery were satisfaction with incontinence products (79%), concerns about surgical risks (53%), and doubts about success of surgery (51%). Fifty-nine percent men reported no knowledge of surgical PPI treatment. Independent predictors of lacking knowledge were low urine loss (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.3-4.7), less severe King's Health Questionnaire (KHQ)-score "role limitation" (OR 2.2, 95% CI 1.1-4.3), concerns about treatment success (OR 2.2, 95% CI 1.2-4.1), and missing information from the urologist (OR 4.2, 95% CI 1.1-16.7) or partner (OR 2.0, 95% CI 1.2-3.8). Limitations of the study include self-reported data and a nonvalidated definition of "knowledge."
Among patients with PPI for ≥12 mo after radical prostatectomy, more than half did not have any knowledge of potentially effective surgery. Information deficits and symptom severity influence knowledge. Strengthening guideline-based information and clinician-patient communication may help close this gap.
PMID:
42383188
Bibliographic data and abstract were imported from PubMed on 01 Jul 2026.
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