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20.06.2020 | Original Article | Ausgabe 3/2021

International Urogynecology Journal 3/2021

Short-, mid-, and long-term incontinence outcomes in women undergoing mid-urethral sling procedures: a retrospective cohort study

Zeitschrift:
International Urogynecology Journal > Ausgabe 3/2021
Autoren:
Joseph M. Malek, Lindsay M. Kissane, Kimberly D. Martin, Isuzu Meyer, Thomas Clark Powell, Holly E. Richter
Wichtige Hinweise
Presented as an oral poster at the Society of Gynecologic Surgeons Annual Meeting, March 31–April 3, 2019, Tucson, Arizona.
A comment to this article is available online at https://​doi.​org/​10.​1007/​s00192-020-04433-y.

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Abstract

Introduction and hypothesis

The primary aim was to compare subjective treatment success among women in short-, mid-, and long-term follow-up after mid-urethral sling (MUS). Symptom severity, condition-specific quality of life (QOL), and patient satisfaction were also examined.

Methods

Women undergoing a primary MUS between 2001 and 2010 were identified by CPT code. Eligible subjects were mailed the Urogenital Distress Inventory (UDI-6), Pelvic Floor Impact Questionnaire (PFIQ-7), Patient Global Impression of Improvement (PGI-I), and Patient Satisfaction Questionnaire (PSQ). Follow-up intervals were short term (≤ 36 months), mid term (37–70 months), and long term (119–200 months). The primary outcome of treatment success was defined as responses of “not at all” or “somewhat” to both stress urinary incontinence (SUI) subscales on the UDI-6.

Results

Of 896 respondents, 361 were assessed in the short-term (23.3 ± 7.2 months), 251 in the mid-term (49.8 ± 9.1 months), and 284 in the long-term group (147.9 ± 20.6 months). Treatment success was 75.4% in the short-, 62.3% in the mid-, and 67.0% in the long-term groups (p < 0.01). Logistic regression showed women with mid- and long-term follow-up were nearly half as likely as their short-term counterparts to report treatment success (adjusted odds ratio [aOR] 0.51, 95% confidence interval [CI] 0.36, 0.74). UDI-6 and PFIQ-7 scores differed significantly among the short-, mid- and long-term groups (p < 0.01). Patient satisfaction was similar, 83.3% in the short-, 76.6% in the mid-, and 78.2% in the long-term follow-up (p = 0.31).

Conclusion

Women with short-term follow-up had the highest subjective treatment success rates; mid- and long-term follow-up was lower, but sustained after 3 years. Symptom severity and impact on QOL were lowest in the short-term group. However, high satisfaction was noted across all groups.

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