Patient-reported outcome measures (PROMs) are important for understanding the success of surgery for stress urinary incontinence, as patient perception of success does not always correlate with physician perception of success. We report PROMS after single-incision slings (SIS) and transobturator mid-urethral slings (TMUS).
This was a planned outcome analysis of secondary endpoints in a study in which the primary aim was to compare efficiency and safety using a non-inferiority design (results reported previously). In this analysis of quality of life (QOL), validated PROMs were collected at baseline, 6, 12, 18, 24, and 36 months to quantify incontinence severity (Incontinence Severity Index), symptom bother (Urogenital Distress Inventory), disease-specific QOL impact (Urinary Impact Questionnaire), and generic QOL impact (PGI-I; not applicable at baseline). PROMs were analyzed within treatment groups as well as between groups. Propensity score methods were used to adjust for baseline differences between groups.
A total of 281 subjects underwent the study procedure (141 SIS, 140 TMUS). Baseline characteristics were balanced after propensity score stratification. Participants had significant improvement in incontinence severity, disease-specific symptom bother, and QOL impact. Improvements persisted through the study and PROMs were similar between treatment groups in all assessment at 36 months CONCLUSIONS: Following SIS and TMUS, patients with stress urinary incontinence had significant improvement in PROMs including Urogenital Distress Inventory, Incontinence Severity Index, and Urinary Impact Questionnaire at 36 months, indicating disease-specific QOL improvement. Patients have a more positive impression of change in stress urinary incontinence symptoms at each follow-up visit, indicating generic QOL improvement.
International urogynecology journal. 2023 Apr 26 [Epub ahead of print]
Ricardo R Gonzalez, Anna Rosamilia, Karyn Eilber, Bruce S Kahn, Amanda B White, Jennifer T Anger
Urology and Female Pelvic Medicine and Reconstructive Surgery, Houston Methodist Hospital, Houston, TX, 77030, USA. ., Department of Obstetrics and Gynaecology, Monash Medical Centre and Cabrini Hospital, Melbourne, Australia., Division of Urology, Cedars-Sinai Health System, Los Angeles, CA, USA., Department of Obstetrics and Gynecology, Scripps Clinic, San Diego, CA, USA., Department of Women's Health, Dell Medical School, University of Texas at Austin, TX, USA, Austin, USA., Department of Urology, University of California San Diego Health, San Diego, CA, USA.