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January 20, 2026World Journal of Urology1 citationsOpen Access

Barriers to post-prostatectomy stress incontinence care: knowledge gaps, patient concerns, and urologist communication

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VMViktoria MenzelCGChrister GroebenFHF. Hoffmann

Key Points

  • This research aims to assess patients' knowledge of stress urinary incontinence treatments and identify barriers to care after prostatectomy.
  • Analyzed follow-up data from the HAROW study and a cross-sectional study from Dresden.
  • Included men who underwent prostatectomy up to 15 years prior and used at least 2 pads daily.
  • Surveyed awareness of treatment options, continence aids, and barriers to therapy.
  • 70% of participants reported continuous leakage post-surgery.
  • 62% lacked knowledge of surgical treatments available.
  • Main reasons for not pursuing surgery included being able to cope with pads and concerns about efficacy and health risks.

Abstract

Abstract Purpose Stress urinary incontinence (SUI) after radical prostatectomy markedly reduces quality of life, yet care gaps remain. This study evaluated patients’ knowledge of treatment options and use of continence aids. Methods We analysed follow-up data from the multicentre HAROW study (2013–2018) and a cross-sectional study from Dresden (2021). Included were men up to 15 years after prostatectomy using ≥ 2 pads daily. The survey examined awareness of surgical treatments, continence aids, information sources, and barriers to therapy. Results Ninety-nine patients participated (HAROW: 62; Dresden: 37). Median age at surgery was 67 years (47–85); median postoperative interval 11 years (0–15). Continuous leakage was reported by 70% (68/97), and 53% (51/96) used > 3 pads/day. Pads were the main aid (97%, 93/96); condom catheters (12%) and penile clamps (2%) were rarely used, with 86% unaware of these options. Knowledge of surgical treatments was absent in 62% (55/89). Better awareness was linked to younger age ( p = 0.002) and fewer pads used ( p = 0.04). Urologists were the main information source (88%), followed by treating hospital (50%) and partners (44%). Key reasons for not seeking surgery were sufficient coping with pads (69%), doubts about efficacy (55%), and fear of health risks (44%). Conclusion Most men with SUI after prostatectomy remain poorly informed about surgical options despite frequent urologist consultations. Fear and misconceptions limit therapy uptake. Structured, targeted education is needed to bridge the gap between clinical need and treatment, potentially improving utilization and quality of life.

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Cite This Study

Menzel et al. (2026) studied this question.

synapsesocial.com/papers/696f1ac19e64f732b51ef028https://doi.org/10.1007/s00345-026-06185-8
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