Table 1:

Participant Quotes by Attribute

ATTRIBUTE	PARTICIPANT	QUOTE
Dryness	14	Success meant not being incontinent. I mean the idea was just tossing away the pads.
	11	Being incontinent is terrible when you’re wet all the time… It’s horrible. So, any improvement was acceptable to me.
	22	Just being able to logistically be more free… just changing a pad once a day…is just much less than having to pack full packs of pads around with me and to have a plastic bag ready to throw the used ones in.
	7	I got so depressed, I wanted to commit suicide. You just couldn’t do anything. In fact, I told friends that I wish I had just let the cancer catch up with me because it probably would have taken several years, but I would have had years where I lived with a normal life.
	29	I thought about ‘What if there comes a time when I’m not well enough to do anything or if I have arthritis and I can no longer manage the valve down there, and it stops working then I’m going to be leaking like a sieve and anyone who has to take care of me or help me, that’s going to be horrible.’… And so at least a backup, at least the sling, there will be something; it won’t just be running out every time you stand up.
Simplicity	29	My notion is to do the sling first.’ … I said ‘If it doesn’t really work the way I think it could work, can we do the sphincter afterwards?’ He said “Yes, we could do that.” so I said ‘Okay, I want to do the sling.’
	25	So I’m not against the operation. I’m just worried about the mechanics of it; it’s just so mechanical and inside my body.
	15	Oh, yeah. Um, my sense was that the sling was pretty innocuous and the sphincters are pretty obviously harmful. I mean I understand how they work and the urethral sphincter strikes me as something that I would never recommend to anybody. It’s a plastic thing squishing a living thing and the chances that it’s going to do that again and again forever and ever without the living thing dying or developing a hole, or something like that, struck me as pretty small.
Need for future intervention	29	I finally did the sling surgery, although it was really not suggested that the sling would be good for me. He felt that the artificial sphincter would be the thing. But I’m an ex-med device guy and I’d read up on the artificial sphincter and it could be three years before you have to change out, it could be five, it could be six months. It all depends… It’s just a bunch of tubes and a pretty simple mechanism, but I guess you still have failures anyway…
	20	The principle thing in my mind was that [the surgeon] said “These things do fail. They don’t—there are always situations where your body rejects them or what have you.” Basically what he suggested to me wasn’t a single surgery where you could implant it and be done with it.
	29	Well, my goal was not to have surgery every three years. I was really concerned about my age. I was 73 when I had my surgery, now I’m about to be 76, and soon I’ll be 80 something. I know some people have been changed out a couple of times and I know that things happen, and you could have erosion and wearing through your urethra and they have to move it around to change it.
Treatment regret/satisfaction	13	I actually wished that I had someone to talk to. Like I said, I did a lot of research online but I also wish that I had someone to talk to before I went into this. Not that I probably would have changed my mind because my mind was set, but just to hear the stories. You know? It would have been good to hear other people’s experiences.
	15	It seems obvious that someone would like to know what are the chances that this surgery will fail, what are the chance that I’m going to need to get it re-done, what are the risks of infection, what are the chances that am I going to be worse off than I am today? If you list all those chances, and you put the statistics by them… I don’t think that informs anybody about anything. I don’t think it addresses the question, ‘Am I going to wish that I hadn’t done this?’
Surgical avoidance	31	I would not be open to surgery under any circumstances.
	27	I was still so traumatized by the surgery of the RP…I think it was just I didn’t want to ever have another surgery… Stress comes up when I think about any kind of surgery, and the stupid decision I made to go ahead with the RP.
	24	Just a major surgical procedure, and since I’d already been through a prostatectomy plus two inguinal hernia repairs after that, I wasn’t too keen on more surgeries… Well, to have more surgery, it might not work, and from my initial—my inguinal hernia repairs—I’ve been left with some pain and tenderness in my lower abdomen as a result of cutting the nerves, and I just didn’t want to do it anymore.
	20	[W]hen you’re in your 70’s you’re not actually anxious to have surgery, you don’t feel like you have the recuperative power that you had when you were younger. And I just came to the conclusion that a serious surgery has lots of recuperative stuff that I didn’t have to worry about when I was younger…Everything bounced always back, it just healed up, and went on with life. And I just realized that that just doesn’t happen. And as you get older, it’s harder to overcome those things.
	29	I have a good [doctor] friend of mine … He avoids going under for whatever reason, because it’s not good for your memory and dementia. He said, ‘Every time you go under, you stand a chance coming out not as good as you were before.’ And I thought ‘How many times do I want to go under and have a major surgery?’ It’s always impacted how I think about going under again.
	31	You know, walking around with advanced stage-4 cancer for 12 years, you have to be optimistic. I mean, every day is a gift. So, you know, would I choose to spend a gift in the hospital? No.