Urinary incontinence is a common complication to radical prostatectomy and pelvic floor muscle training (PFMT) is recommended to decrease incontinence symptoms (1). A mobile app can support this training (2). The aim of this study was to analyse possible changes in the need of healthcare contacts among men who have had radical prostatectomy and use an app for their PFMT. Also, to analyse possible savings for the healthcare system and reductions of carbon dioxide emissions.

A prospective cohort study based on data from anonymous survey responses from users of an app between 7 June 2023 and 28 February 2024. We included Swedish men who used the app for three months and had had a radical prostatectomy within three months before or after downloading the app. The app contains a PFMT program with a training log and reminders, as well as information about prostatectomy and urinary incontinence. Survey questions in the three months follow-up included the perceived change in need of phone contacts and physical appointments to the healthcare for questions about PFMT or urinary incontinence, as well as distance to the healthcare facility and means of travel. We calculated a possible economic saving for the healthcare based on the cost for a visit to a nurse or doctor respectively in the urology department in northern Sweden. Based on the participants’ travel information and saved visits we calculated an avoided emission of carbon dioxide.

217 men were included (mean age 64 years). Almost half of the participants experienced a decreased need for phone contact with the healthcare and about a fourth reported a decreased need of physical appointments. During three months, at least 131 visits were reported to be saved in on to the healthcare, which corresponds to a cost of 49 787 – 73 517 EUR, a mean of 21 – 30 EUR per study participant and three months. The calculation of the avoided commute showed that 4 288 km was avoided which corresponds to a total of 0.82 tons of carbon dioxide.

A limitation to this study is that data is self-reported. A strength is that it is a relatively large study and the mean age of the participants correspond well with the age of men undergoing prostatectomies in Sweden. Since prostate cancer is one of the most common cancers in the world there are many potential users of an app to support PFMT for men who have undergone radical prostatectomy, both in Sweden and globally, and minor savings on healthcare costs or emission has the possibility to give major effects.

Men who have had radical prostatectomy and use an app for PFMT report a decreased need of phone contacts and physical appointments to the healthcare. This could save in on costs for the healthcare and carbon dioxide emissions from patient commute.

Bhatt NR, Pavithran A, Ilie C, Smith L, Doherty R. Post-prostatectomy incontinence: a guideline of guidelines. BJU Int. 2024 May;133(5):513-523.
Al-Zaidi Z, Lindam A, Fransson P, Samuelsson E. A mobile app as support for pelvic floor muscle training started prior to radical prostatectomy. BJUI Compass. 2023;4(1):114-22.