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Patient satisfaction after midurethral sling surgery for stress urinary incontinence.
Obstet Gynecol. 2013 May; 121(5):1009-1016.OG

Abstract

OBJECTIVE

To identify factors that may contribute to patient satisfaction with outcome in women who received retropubic and transobturator midurethral slings.

METHODS

Satisfaction was assessed 12 months postsurgery as a planned analysis in 597 participants from a multicenter randomized trial comparing retropubic with transobturator midurethral slings using the Incontinence Surgery Satisfaction Questionnaire. Significantly related variables associated with satisfaction in univariable analyses were entered into multivariable logistic regression models to test their independent association with satisfaction.

RESULTS

One year after surgery, 264 (88.6%) in the retropubic group and 263 (88.0%) in the transobturator group completed satisfaction questionnaires. Both treatment groups demonstrated a high level of satisfaction with respect to urine leakage (retropubic 85.9% compared with transobturator 90.0%; P=.52), urgency to urinate, frequency of urination, capability of physical activity, social activity, ability to engage in sexual activity, and from an emotional standpoint. Baseline characteristics associated with reduced satisfaction were higher Medical, Epidemiologic, and Social Aspects of Aging Questionnaire urgency subscale scores, detrusor overactivity, and diabetes mellitus. The severity of both objective (frequency of incontinence episodes, pad test weight) and subjective (Incontinence Impact Questionnaire and Urogenital Distress Inventory score) measures of incontinence at baseline and the patients' perceptions of preoperative severity of incontinence and expectations of achieving postoperative cure or improvement were not statistically different between satisfied and unsatisfied patients. In the final multivariable model, satisfaction was associated with overall treatment success (odds ratio [OR] 2.57, 95% confidence interval [CI] 1.29-5.13], greater reduction in Urogenital Distress Inventory (OR 0.97, 95% CI 0.96-0.98) and Incontinence Impact Questionnaire scores (OR 0.99, 95% CI 0.98-0.99), and fewer complications (OR 0.55, 95% CI 0.30-0.99).

CONCLUSION

The high level of satisfaction seen after midurethral sling procedures is associated with greater objective and patient-perceived improvement of stress incontinence and fewer complications.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, www.clinicaltrials.gov, NCT00325039.

LEVEL OF EVIDENCE

II.

Authors+Show Affiliations

University of Texas Southwestern, Dallas, Texas; the New England Research Institutes, Watertown, Massachusetts; the University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Veterans Affairs and The University of Alabama at Birmingham, Birmingham, Alabama; Loyola University Stritch School of Medicine, Chicago, Illinois; the University of Maryland, Baltimore, Maryland; and the University of California, San Diego, California.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23635737

Citation

Wai, Clifford Y., et al. "Patient Satisfaction After Midurethral Sling Surgery for Stress Urinary Incontinence." Obstetrics and Gynecology, vol. 121, no. 5, 2013, pp. 1009-1016.
Wai CY, Curto TM, Zyczynski HM, et al. Patient satisfaction after midurethral sling surgery for stress urinary incontinence. Obstet Gynecol. 2013;121(5):1009-1016.
Wai, C. Y., Curto, T. M., Zyczynski, H. M., Stoddard, A. M., Burgio, K. L., Brubaker, L., Rickey, L. M., & Menefee, S. A. (2013). Patient satisfaction after midurethral sling surgery for stress urinary incontinence. Obstetrics and Gynecology, 121(5), 1009-1016. https://doi.org/10.1097/AOG.0b013e31828ca49e
Wai CY, et al. Patient Satisfaction After Midurethral Sling Surgery for Stress Urinary Incontinence. Obstet Gynecol. 2013;121(5):1009-1016. PubMed PMID: 23635737.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patient satisfaction after midurethral sling surgery for stress urinary incontinence. AU - Wai,Clifford Y, AU - Curto,Teresa M, AU - Zyczynski,Halina M, AU - Stoddard,Anne M, AU - Burgio,Kathryn L, AU - Brubaker,Linda, AU - Rickey,Leslie M, AU - Menefee,Shawn A, AU - ,, PY - 2013/5/3/entrez PY - 2013/5/3/pubmed PY - 2013/7/3/medline SP - 1009 EP - 1016 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 121 IS - 5 N2 - OBJECTIVE: To identify factors that may contribute to patient satisfaction with outcome in women who received retropubic and transobturator midurethral slings. METHODS: Satisfaction was assessed 12 months postsurgery as a planned analysis in 597 participants from a multicenter randomized trial comparing retropubic with transobturator midurethral slings using the Incontinence Surgery Satisfaction Questionnaire. Significantly related variables associated with satisfaction in univariable analyses were entered into multivariable logistic regression models to test their independent association with satisfaction. RESULTS: One year after surgery, 264 (88.6%) in the retropubic group and 263 (88.0%) in the transobturator group completed satisfaction questionnaires. Both treatment groups demonstrated a high level of satisfaction with respect to urine leakage (retropubic 85.9% compared with transobturator 90.0%; P=.52), urgency to urinate, frequency of urination, capability of physical activity, social activity, ability to engage in sexual activity, and from an emotional standpoint. Baseline characteristics associated with reduced satisfaction were higher Medical, Epidemiologic, and Social Aspects of Aging Questionnaire urgency subscale scores, detrusor overactivity, and diabetes mellitus. The severity of both objective (frequency of incontinence episodes, pad test weight) and subjective (Incontinence Impact Questionnaire and Urogenital Distress Inventory score) measures of incontinence at baseline and the patients' perceptions of preoperative severity of incontinence and expectations of achieving postoperative cure or improvement were not statistically different between satisfied and unsatisfied patients. In the final multivariable model, satisfaction was associated with overall treatment success (odds ratio [OR] 2.57, 95% confidence interval [CI] 1.29-5.13], greater reduction in Urogenital Distress Inventory (OR 0.97, 95% CI 0.96-0.98) and Incontinence Impact Questionnaire scores (OR 0.99, 95% CI 0.98-0.99), and fewer complications (OR 0.55, 95% CI 0.30-0.99). CONCLUSION: The high level of satisfaction seen after midurethral sling procedures is associated with greater objective and patient-perceived improvement of stress incontinence and fewer complications. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00325039. LEVEL OF EVIDENCE: II. SN - 1873-233X UR - https://www.unboundmedicine.com/medline/citation/23635737/Patient_satisfaction_after_midurethral_sling_surgery_for_stress_urinary_incontinence_ L2 - https://doi.org/10.1097/AOG.0b013e31828ca49e DB - PRIME DP - Unbound Medicine ER -