Understanding the Health Characteristics and Treatment Choices of Older Men with Stress Urinary Incontinence
| Autor: | Lillian Y. Lai, Matthew R. Cooperberg, Benjamin N. Breyer, Salomeh Keyhani, Anne M. Suskind, Lindsay A. Hampson, Rebecca L. Sudore, I. Elaine Allen, Louise C. Walter |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Urologic Diseases Aging medicine.medical_specialty Activities of daily living Urology Clinical Sciences Population 030232 urology & nephrology Urinary incontinence Stress Basic Behavioral and Social Science Article 03 medical and health sciences 0302 clinical medicine 7.1 Individual care needs Quality of life Clinical Research Behavioral and Social Science Humans Medicine education Depression (differential diagnoses) Retrospective Studies Aged education.field_of_study business.industry Patient Preference Urology & Nephrology Brain Disorders Urinary Incontinence Mental Health Good Health and Well Being 030220 oncology & carcinogenesis Cohort Physical therapy Life expectancy Anxiety Management of diseases and conditions medicine.symptom business |
| Zdroj: | Urology |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/j.urology.2021.05.002 |
| Popis: | 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 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. |
| Databáze: | OpenAIRE |
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