Quality of Information on YouTube Regarding Female Stress Incontinence Treatment

Objectives: Stress urinary incontinence (SUI) is a common issue that affects women globally. In the era of the Internet, patients seeking more information turn to this widely available resource. YouTube is a platform that lends itself to short and long format videos that can provide education, resources, and patient experiences regarding various conditions including SUI. Our study seeks to assess the quality of information regarding treatment of female SUI on YouTube. Our secondary aim is to assess if the treatments mentioned in the YouTube videos are included in the SUFU/AUA guidelines regarding treatment of female SUI.

Methods: A search was performed on YouTube for the term: “female stress urinary incontinence treatment”. The first 50 “top relevant” (default search setting) videos were selected. Duplicates and videos not in English were excluded. Four physicians served as independent raters and were randomly assigned with two raters per video. Each rater completed two validated instruments to assess the quality and accessibility of the videos as patient resources: the “DISCERN” questionnaire and the “PEMAT-AV” tool. A fifth rater was available for videos rated discordantly. Information regarding video characteristics was also collected including view count, length, source of video, and treatments suggested.

Results: Video characteristics are included in Table 1. Mean PEMAT-AV understandability subscore was 79.2% (range 33%-100%). Mean PEMAT-AV actionability score was 66.4% (range 0-100%). Mean responses to DISCERN questions are included in Table 2; mean DISCERN score was 2.98 (range 1-5). 50% of videos mentioned treatment options not included in the guidelines (Table 1), including weight loss, quitting smoking, and electromagnetic pelvic floor stimulation.

Conclusions: Our study shows that videos on YouTube regarding treatment of female stress urinary incontinence contain moderate quality information as assessed by the validated DISCERN and PEMAT-AV tools. Videos were understandable but did not all contain actionable next steps for viewers interested in pursuing treatment. Per the DISCERN tool, videos scored moderately as sources of information regarding treatment choices. In particular, videos scored poorly on the following domains: reporting areas of uncertainty, describing risks of treatment, and describing what would happen if no treatment was pursued. Many videos included treatment options not included in the AUA/SUFU guidelines. There is an opportunity to provide higher quality and more actionable patient materials on websites like YouTube to assist in the shared decision-making process.