The expectations of patients who undergo surgery for stress incontinence

Mallett, Veronica; Brubaker, Linda; Stoddard, Anne M.; Borello‐France, Diane; Tennstedt, Sharon L.; Hall, Lynn; Hammontree, Lee N.

doi:10.1016/j.ajog.2007.09.003

Cited by 47 publications

(26 citation statements)

References 17 publications

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“…32 Quality of life is improved by the majority of women after any UI treatment. [33][34][35] Strengths of this case series include those associated with academic referral centers including overall cohort size and patient diversity. Our findings may be generalized to other similar centers in the US performing prosthetic implant removal procedures.…”

Section: Discussionmentioning

confidence: 99%

Symptom Improvement After Prolapse and Incontinence Graft Removal in a Case Series of 306 Patients

Rogo-Gupta¹,

Grisales²,

Huynh³

et al. 2015

Female Pelvic Medicine &Amp; Reconstructive Surgery

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Section: Discussionmentioning

confidence: 99%

Symptom Improvement After Prolapse and Incontinence Graft Removal in a Case Series of 306 Patients

Rogo-Gupta¹,

Grisales²,

Huynh³

et al. 2015

Female Pelvic Medicine &Amp; Reconstructive Surgery

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“…The effect of surgery on bladder storage symptoms of the overactive bladder (OAB) syndrome (10) namely urinary urgency, frequency and nocturia with or without urgency urinary incontinence is poorly understood. In a multicenter study comparing Burch and autologous fascial slings, nearly all (92%) women with mixed incontinence expected their co-existent urgency, frequency and nocturia would also improve after their SUI surgery despite counseling efforts to the contrary (11). Thus, persistence of any storage symptoms, not just urgency incontinence, can deleteriously affect a patient’s perception of surgical success and satisfaction.…”

Section: Introductionmentioning

confidence: 99%

Change in Overactive Bladder Symptoms After Surgery for Stress Urinary Incontinence in Women

Zyczynski

Albo

Goldman

et al. 2015

Obstetrics &Amp; Gynecology

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OBJECTIVE To assess change in overactive bladder (OAB) symptoms up to 5-years after surgery and to identify associated predictors of change from baseline. METHODS This is a secondary analysis of data from three multicenter urinary incontinence surgical trials of women with stress predominant mixed urinary incontinence assigned to Burch colposuspension, autologous fascial sling, retropubic or transobturator midurethral slings. The primary outcome was improvement of ≥70% from baseline in symptoms measured by the Urinary Distress Inventory–Irritative (UDI-I) subscale. Surgical groups were compared within respective trials. Generalized linear models were fit using 1-year and up to 5-year data. RESULTS Significant improvements in UDI-I scores were reported by each surgical group one year after surgery (p<0.001). Most women (50–71%) reported improvement in OAB symptoms. Improvements were similar between midurethral sling groups at 1-year (65.5% vs 70.7%, p=0.32) (OR=0.83 [95% CI 0.57–1.20] for retropubic vs. transobturator sling) and throughout the 5-year follow-up period. More women reported OAB symptom improvement after Burch compared to pubovaginal sling (67.9% vs 56.6%, p=0.01) (OR=1.59 [95% CI 1.10–2.31] for Burch vs. sling); this group difference at 1-year persisted throughout the 5-year follow-up. At 1-year, 50.0–64.3% of patients reported ≥70% improvement in urgency incontinence. This proportion declined to 36.5–54.1% at 5-years (p<0.001). Preoperative use of anticholinergics and urodynamic parameters were not predictive of OAB symptom change after surgery. CONCLUSIONS Most women with stress predominant mixed urinary incontinence experienced significant improvement in OAB symptoms after incontinence surgery although this initial improvement diminished over time. Obesity blunted symptom improvement.

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“…Similarly, in patients specifically with stress UI, 22% expected a complete cure and 57% a good improvement from treatment; interestingly, patients with more severely affected QoL and greater severity of symptoms had higher expectations of cure or improvement than those less severely affected, although most were accepting of the potential for use of a pantiliner for security after treatment [29]. However, of patients enrolled in a large, randomized, prospective trial for surgical treatment of stress UI (SISTEr [Stress Incontinence Surgical Treatment Efficacy Trial]), 98% expected complete resolution of their urine leakage symptoms after surgical intervention [30]. Surprisingly, however, of the patients reporting urgency or frequency, 92% and 83%, respectively, expected those symptoms to improve with stress UI-specific surgical intervention.…”

Section: Evolving Aspects Of Patient-reported Outcomesmentioning

confidence: 94%

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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The expectations of patients who undergo surgery for stress incontinence

Cited by 47 publications

References 17 publications

Symptom Improvement After Prolapse and Incontinence Graft Removal in a Case Series of 306 Patients

Symptom Improvement After Prolapse and Incontinence Graft Removal in a Case Series of 306 Patients

Change in Overactive Bladder Symptoms After Surgery for Stress Urinary Incontinence in Women

Outcomes and Pelvic Floor Interventions: Can We Predict?

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