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. 2025 May 26;43(1):329.
doi: 10.1007/s00345-025-05668-4.

The views of women and their physicians on decision-making for stress urinary incontinence

Nienke J E Osse  1   2 , Karine Gontijo-Santos Lima  3 , Marian K Engberts  4 , Hugo W F van Eijndhoven  4 , Philippe D Violette  5 , Rufus Cartwright  6 , Marco H Blanker  3 , Paul L P Brand  7   8
Affiliations

The views of women and their physicians on decision-making for stress urinary incontinence

Nienke J E Osse et al. World J Urol. .

Abstract

Introduction: Treatment decisions for stress urinary incontinence (SUI) are preference sensitive, because the disease is non-lethal and there are multiple reasonable treatment options. However, little is known about patients' and physicians' preferred decision-making styles for SUI. To aid physicians in their counselling and decision-making in consultations for SUI, we studied patients' and physicians' preferred and perceived decision-making in medical specialist consultations for SUI.

Methods: This mixed-methods study combined the validated control preference scale (CPS) and the CPS perception version, and semi-structured, in-depth interviews with both patients and physicians. This study took place in Canada, the United Kingdom and the Netherlands. Sixteen physicians from all three countries and seventeen women from the Netherlands and Canada were interviewed.

Results: All women expressed a preference for being involved in the decision-making process, either by informative or shared decision-making (SDM) in the CPS, because they valued the autonomy to make their own choice regarding treatment for SUI and appreciated receiving information and advice from their doctor. Physicians also preferred an involved patient, but used medical expertise to steer towards their preferred treatment option. Physicians found SDM difficult to understand, expressing different interpretations.

Conclusions: SDM is not a precise concept either for patients or physicians, with multiple interpretations. All patients with SUI want to be involved in the decision-making process, either by informative or by shared decision-making. Physicians both express the desire to involve patients in their decision making, but conversely to steer patients towards the decision that they feel suits them best.

Keywords: Mixed-methods study; Patient perceptions; Physician perceptions; Shared decision-making; Stress urinary incontinence; Treatment decision.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Themes and subthemes identified in the interviews
See this image and copyright information in PMC

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