Outcome measures and definition of cure in female stress urinary incontinence surgery: a survey of recent publications

Castillo, P.; Espaillat-Rijo, Luis M.; Davila, G. Willy

doi:10.1007/s00192-009-1032-5

Cited by 25 publications

(37 citation statements)

References 11 publications

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“…It would seem that most clinical studies now incorporate some degree of PROs as a measure of assessment [18]. However, it remains unclear how PROs are being used and what role they play in determining overall study end points.…”

Section: Current Use Of Patient-reported Outcomes In the Pelvic Floormentioning

confidence: 98%

“…[18] performed a systematic literature review of published studies involving surgical treatment of female stress UI to review the use of outcome measures. A total of 91 studies published between 2005 and 2006 were analyzed, and most (96%) used either subjective outcome measures only (33%) or both objective and subjective measures (63%) in their outcome assessments.…”

mentioning

confidence: 99%

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Outcomes and Pelvic Floor Interventions: Can We Predict?

Reynolds

Kaufman

Dmochowski

2010

Curr Bladder Dysfunct Rep

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An evolving trend in reporting outcomes after pelvic floor interventions is focusing increasingly on patient-reported outcomes as assessments of pelvic floor conditions and of results after intervention. Efforts have been made to scientifically validate patient-reported outcomes instruments and to standardize their use in clinical research. Additionally, guidelines have been published recommending minimum requirements for incorporating patient-reported outcomes in peer-reviewed publications. Although an increasing number of publications are incorporating patient-reported outcomes, how these data are being used remains unclear, as many studies are not using patient-reported outcomes data as primary end points or in definitions of cure. More widespread adoption of standardized outcomes measures will better ensure more quality clinical research as well as comparability between studies.

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Section: Current Use Of Patient-reported Outcomes In the Pelvic Floormentioning

confidence: 98%

mentioning

confidence: 99%

Outcomes and Pelvic Floor Interventions: Can We Predict?

Reynolds

Kaufman

Dmochowski

2010

Curr Bladder Dysfunct Rep

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show abstract

“…Ninety-six percent of recent articles reporting on surgical outcomes for female stress incontinence use subjective outcome measurements [1]. Questionnaires are useful for research purposes and shorter questionnaires in particular can be integrated into routine clinical practice to complement history taking, enhance effective communication, and, in some cases, guide treatment efforts.…”

Section: Introductionmentioning

confidence: 99%

“…Our goal was to (1) create Spanish versions of four important pelvic floor disorders questionnaires using culturally sensitive methods recommended by modern cross-cultural researchers and (2) validate these Spanish questionnaires for clinical and research use in the Spanish-speaking US and Latin American populations.…”

Section: Introductionmentioning

confidence: 99%

Spanish translation and validation of four short pelvic floor disorders questionnaires

et al. 2012

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“…Castillo et al [2] analyzed 91 surgical series of SUI and reported that 33% of these studies used only subjective measures, 4% only objective measures, and 63% both objective and subjective measures, for the definition of "cure." Not surprisingly, therefore, the cure rates of the same surgical procedure for SUI differed among these studies.…”

mentioning

confidence: 99%

Subjective versus objective measurement of surgical outcomes of treatment of female stress urinary incontinence: it is not just black and white

Haliloğlu

Rizk

2010

Int Urogynecol J

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The best interest of the patient is the only interest to be considered.William J. MayoStress urinary incontinence (SUI) is encountered in as many as 20% of women with adverse social and hygienic consequences [1]. Recently, most studies have shown that the majority of surgical procedures, particularly the minimally invasive midurethral slings, are both safe and effective treatment of female SUI. However, the success rates reported varied between studies, depending on whether objective or subjective outcomes had been measured. The postoperative objective and subjective cure rates were not also correlated in most of these studies. For example, a recent review gives a very wide range of short-term success rates of various surgical procedures for treatment of female SUI, from 32% to 100% [1]. It is extremely important that comparison of the results of surgical treatment of SUI between different surgeons and centers as well as patient counseling is based on robust scientific evidence that includes valid and accurate assessment of the treatment outcome. It seems timely, therefore, to discuss this topic further mainly by addressing three main questions: What do we mean by surgical cure of SUI? How do we measure this cure? What is the definition of success of operative intervention for SUI?There has been a lack of consensus in the urogynecologic community about which postoperative outcome measure to use to evaluate the efficacy of surgical procedures for SUI. Castillo et al. [2] analyzed 91 surgical series of SUI and reported that 33% of these studies used only subjective measures, 4% only objective measures, and 63% both objective and subjective measures, for the definition of "cure." Not surprisingly, therefore, the cure rates of the same surgical procedure for SUI differed among these studies. A universal definition of cure is thus obviously needed for accurate interpretation of cure rates when surgical treatment of SUI is contemplated.Surgeons tend to define the cure of SUI as the successful anatomical repair of defective tissue support of the urethra measured by objective improvement in urinary incontinence. As a direct result, earlier studies of surgical treatment of SUI focused on objective outcomes for measurement and definition of "surgical" cure. However, these measures tend to underestimate the impact of lower urinary tract symptoms on social limitations and emotional well-being of the woman [3]. Patients may have completely different expectations of cure after surgery for SUI other than the anatomical cure, such as absence of odor, lack of disruption of routine activities, use of less pads, and/or improvement of emotional status. For patients, the improvement of these symptoms might be more important than the "objective" demonstration of leakage of urine. In fact, a number of patients who are considered as objectively cured from SUI might even feel worse following the operation due to surgery-induced negative outcomes such as de novo urge urinary incontinence or intermittent selfcatheterization because of voi...

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Outcome measures and definition of cure in female stress urinary incontinence surgery: a survey of recent publications

Abstract: Outcome measures used to evaluate success of anti-incontinence procedures lack consensus and comparability.

Cited by 25 publications

References 11 publications

Outcomes and Pelvic Floor Interventions: Can We Predict?

Outcomes and Pelvic Floor Interventions: Can We Predict?

Spanish translation and validation of four short pelvic floor disorders questionnaires

Subjective versus objective measurement of surgical outcomes of treatment of female stress urinary incontinence: it is not just black and white

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