Introduction and Hypothesis: Following the design, face validation and publication of a new PDA for women considering SUI surgery, the main objective of the study is to evaluate the SUI-PDA usefulness by using a validated tool to obtain patient feedback.

Methods: From July 2018 to March 2019, the PDA already incorporated into the patient-care pathway was evaluated by patients using the Decisional Conflict Scale (DCS) to objectively determine their views. Patients recorded their values and reasons for requests and declines of treatment. The total DCS score, scores from each subgroup and their responses noted within each individual PDA were calculated and analysed.

Results: The mean age of the first 20 patients to complete the DCS was 54 years old, the mean BMI was 30.1 and the median parity was 3. The average of the total DCS score was 9.29 suggesting that the PDA was quite useful for patients considering SUI surgery. Overall, the PDA had largely favourable responses across all 5 DCS subgroups. The ‘informed’ subgroup had the best score (6.67) while the ‘uncertainty’ subgroup had the least favourable score (14.58). Despite government suspension, the mesh option remained on the PDA but no patient had chosen this option, with a large proportion citing ‘safety’ issues as the main reason. Bulking agent injections were the most popular choice (40.0%) and the most commonly performed procedures (50.0%) mainly due to quicker ‘recovery’. The second most popular participant choice was colposuspension (35.0%) followed by autologous fascial sling (25.0%), with women citing ‘efficacy’ as the main reason behind their choice.

Conclusion: The SUI-PDA was effective and informative to patients considering SUI surgery. However, the relatively high ‘uncertainty’ score suggests there is difficulty for some patients in being certain about their choices. Further work is required to improve patient confidence and reduce ‘uncertainty’. Further validation in a larger patient group is underway.