Stress Urinary Incontinence Survey
1.
Do you have Stress Urinary Incontinence? Stress Urinary Incontinence is the unintentional loss of urine when physical movement or activity, such as laughing, coughing, sneezing, running, or heavy lifting, puts pressure (stress) on your bladder. (Source: Mayo Clinic)
If no, please do not participate in this survey.
Yes
No
2.
What is your age range?
18-24
25-34
35-44
45-54
55-64
65+
Prefer not to answer
3.
Approximately how long did you suffer from Stress Urinary Incontinence before talking to your doctor about treatment options?
0 to 3 months
4 to 6 months
7 to 12 months
1 to 2 years
More than 2 years
4.
Would you be interested in a urethral device to treat your Stress Urinary Incontinence, assuming that it can be inserted via catheter in the doctor's office?
Yes
No
5.
Would you be interested in the device if it had the be replaced once a year?
Yes
No
6.
Would you be interested if the device had to be replaced once every six months?
Yes
No
7.
Are you willing to undergo bladder surgery?
Yes
No
8.
Have you tried pelvic floor or behavioral therapies for your Stress Urinary Incontinence?
Yes - It worked!
Yes - It did not work.
No
9.
Would you seek alternative treatment options if you were still having leaking after trying pelvic floor therapy?
Yes
No