Quantifying the Number of US Men With Incident Persistent Stress Urinary Incontinence

Purpose: Men undergoing prostate-related interventions can develop stress urinary incontinence (SUI), which negatively affects quality of life. Despite effective surgical treatments of persistent SUI, few men receive them. In this study, we quantify the incidence and prevalence of persistent SUI among insured US men and estimated the number of potential candidates for SUI surgical treatment in 2023. Materials and Methods: An Excel-based estimation model identified men with claims for prostate-related procedures (2018-2022) in the Merative MarketScan Commercial Database (men younger than 65 years) and Medicare 5% Standard Analytical Files (men older than 65 years). Patients were categorized into 4 groups: benign prostatic hyperplasia (BPH) procedures, radical prostatectomy (RP) for prostate cancer (PCa), radiotherapy (RT) for PCa, or both RP and RT. Persistent SUI estimates were derived from claims and literature. Results: Persistent SUI ranged from 1.7% (BPH) to 23.2% (RP) in claims data and from 4.2% (BPH) to 30.0% (RP + RT) in the literature. Between 6% (RP + RT) and 12% (RP) of patients with persistent SUI underwent an SUI-related procedure. The incidence of untreated potential candidates for SUI procedures in the United States ranged from 41,085 to 53,163 in 2023, and the prevalence of men with persistent SUI who could benefit from such procedures ranged from 280,404 to 362,839. Conclusions: Approximately 50,000 men in 2023 would have persistent SUI without surgical treatment. Given the burden imposed by SUI and safety and efficacy of surgical treatments of SUI, the low utilization of these therapies indicates a gap in care. While this disconnect may be due to patient preference, efforts to ensure patients receive adequate access to and information about these treatments may help to reduce this gap.