To evaluate patient experience and satisfaction following surgery for post prostatectomy stress incontinence using a validated patient reported experience measure and patient reported outcome measure.

In this single center study, patients who received treatment with a male sling (MS; AdVance XP™) or artificial urinary sphincter (AUS; AMS 800™) who had a minimum of a 1 year follow up were contacted by telephone and completed 2 questionnaires; the client satisfaction questionnaire (CSQ-8), and treatment benefit scale (TBS).  Higher CSQ-8 scores, indicate better service evaluation, and lower TBS greater patient satisfaction with treatment. All patients had failed a trial of pelvic floor exercises, were at least 1 year post prostatectomy and were confirmed to have an open bladder neck with no evidence of stricture. Urodynamics confirmed urodynamic stress urinary incontinence in all patients and in 32% there was also evidence of detrusor overactivity. In general, those with mild to moderate incontinence severity as assessed by number of pads and / or 24 hour pad weights were treated with a MS and those with moderate to severe SUI or a history of radiation with an AUS. This study was approved by our local R&D department no. 7923 as a service evaluation audit.

Sixty-three procedures were undertaken on 62 patients, which included 29 MS and 34 AUS with at least 1 year follow up. Ten patients were not contactable, leaving 53 procedures (27 MS, 26 AUS) in 52 patients. Bothersome stress incontinence was as a result of radical prostatectomy in 92% of cases. The mean follow up was 32 months (range 12 to 53). The mean CSQ-8 score was 30.2 (S.D. 3.60) out of 32. The modal score was 32 (32 out of 53 responses) and scores ranged from 13 to 32. The CSQ-8 average individual mean domains scores ranged from 3.55-3.85 out of 4. The mean TBS score was 1.47 (S.D. 0.82) out of 4 with a modal score of 1 (37 out of 53). Forty-six patients (87%) of our patients gave a score of at least 1 or 2 showing that the treatment either improved or greatly improved their condition.

Response rates were high at 84%. Mean CS-Q 8 scores were high as were all individual domains indicating a very high service evaluation from the study cohort. TBS scores were low indicating high patient satisfaction with treatment.

Our data demonstrates that the majority of our patients were highly satisfied with the service as well as their outcome following post prostatectomy incontinence surgery. Patient reported experience measures in addition to patient reported objective measures should be more widely utilized to fully capture the patient experience.