Correlation of persistent stress urinary incontinence with quality of life after suspension procedures: is continence the only decisive postoperative criterion of success?

• Published in: Urology (Ridgewood, N.J.) Vol. 54; no. 2; pp. 247 - 251
• Main Authors: Filbeck, Thomas, Ullrich, Traugott, Pichlmeier, Ullrich, Kiel, Hans J, Wieland, Wolf F, Roessler, Wolfgang
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-08-1999; Elsevier Science
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Female; Humans; Medical sciences; Middle Aged; Quality of Life; Recurrence; Remission Induction; Retrospective Studies; Self-Assessment; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Surveys and Questionnaires; Urinary Incontinence, Stress - surgery; Human; Postoperative; Urinary system disease; Exploration; Urinary tract disease; Colpopexy; Quality of life; Voiding dysfunction; Urodynamique; Treatment; Surgery; Adult; Evolution; Female; Bladder disease; Bladder neck; Urinary stress incontinence
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/S0090-4295(99)00101-6

Objectives. To determine objective continence rates and to include in the evaluation subjective assessment of continence and quality of life by the affected patients and correlate these with the objective continence rates in a retrospective study.
Methods. One hundred thirty-three female patients in our clinic underwent suspension procedures for stress urinary incontinence, 68 undergoing a Burch colposuspension and 65 a Raz bladder neck suspension. The continence rate was evaluated by questionnaire and compared with patients’ postoperative self-assessment of continence and pre- and postoperative quality of life assessments.
Results. For the 105 women returning evaluable questionnaires (57 Burch and 48 Raz procedure), the continence rate was 69.5% (75.4% in the Burch group, 60.4% in the Raz group). Mild incontinence requiring 1 to 2 sanitary pads daily was found in 19.3% of the Burch group and 31.3% of the Raz group. Moderate incontinence requiring 3 to 5 pads daily was found in 5.3% of the Burch and 8.3% of the Raz group. No patients had severe incontinence (more than 5 pads daily). Both groups showed statistically significant improvement in postoperative quality of life. Despite persistent incontinence, the satisfaction rate was comparable to that of continent patients.
Conclusions. The results show that in addition to objective parameters, subjective assessment of quality of life is a factor that should be included in the postoperative evaluation of surgical results.