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However, there were no statistically significant variations in preference for an improvement from urge incontinence to mild urgency. This may reflect the variation in the sample about the degree of improvement represented by a move from urge incontinence to severe or moderate urgency, and the agreement in the sample about the benefit of the largest improvement from urge incontinence to mild urgency. The side effect of dry mouth also showed no significant preference variation, implying this attribute was not important to men in our sample. The value of reducing day- or nighttime frequency by one time was small compared to the value for a reduction of urgency and side effects Table 4.
The other sexual side effects, no fluid during ejaculation dry orgasm , and decreased sexual desire, had a similar impact on medication value as the nonsexual side effects of headaches and dizziness. Furthermore, the value of reduced urgency to moderate or mild urgency would compensate any one of the side effects, except for erectile dysfunction.
In terms of symptom improvement, reducing urinary urgency was the most important benefit of medication, followed by a one-time reduction in night- and daytime urinary frequency. In terms of side effects, avoiding sexual and nonsexual side effects was also important to men; erectile dysfunction was perceived as the worst side effect. The results also showed preference variations in the importance of medication attributes for treatment choice in the sample.
In contrast, a change from urge incontinence to severe urgency cannot postpone and have to rush to the toilet in order to not wet yourself appeared to have little importance and men were not willing to pay for this level of change. Men also valued reductions in day- and nighttime frequency.
These data are not unexpected given that storage symptoms are reported to impair quality of life 42 , 43 and limit daily activities 44 in men with LUTS. This is consistent with previous DCEs, which reported erectile dysfunction was the least desirable sexual side effect and confirmed the undesirability of decreased sexual desire and no fluid during ejaculation dry orgasm. Such a combination of benefits may compensate for the negative impact of side effects. However, increasing the number of attributes increases the difficulty of completing the tasks, 49 , 50 meaning that respondents may provide less precise answers or may not consider all of the attributes.
We consider that the selection of these seven attributes balances comprehensiveness of the symptoms and medication description and practicality of the survey administration. Another potential limitation of this DCE was that all surveys were completed online thereby excluding men without access to the Internet. Receiving medicines that significantly reduce storage symptoms, such as urge incontinence and nighttime urinary frequency, is perceived as the most important benefit of medication.
However, men would prefer to avoid medicines that are likely to elicit sexual and nonsexual side effects.
All authors contributed toward data analysis, drafting and critically revising the paper and agree to be accountable for all aspects of the work. Lower urinary tract symptoms: The management of lower urinary tract symptoms in men [updated ].
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Male LUTS/BPH Made Easy
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