To describe all outcome parameters and definitions of cure used to report on outcome of surgical interventions for stress urinary incontinence (SUI) in neuro-urological (NU) patients.
This systematic review was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The study protocol was registered and published (CRD42016033303; http://www.crd.york.ac.uk/PROSPERO). Medline, Embase, Cochrane controlled trials databases, and clinicaltrial.gov were systematically searched for relevant publications until February 2017.
A total of 3168 abstracts were screened. Seventeen studies reporting on SUI surgeries in NU patients were included. Sixteen different outcome parameters and nine definitions of cure were used. Six studies reported on objective outcome parameters mainly derived from urodynamic investigations. All studies reported on one or more subjective outcome parameters. Patient-reported pad use (reported during interview) was the most commonly used outcome parameter. Only three of 17 studies used standardized questionnaires (two on impact of incontinence and one on quality of life). Overall, a high risk of bias was found.
We found a considerable heterogeneity in outcome parameters and definitions of cure used to report on outcome of surgical interventions for SUI in NU patients. The results of this systematic review may begin the dialogue to a future consensus on this topic. Standardization of outcome parameters and definitions of cure would enable researchers and clinicians to consistently compare outcomes of different studies and therapies.
Neurourology and urodynamics. 2017 Aug 09 [Epub ahead of print]
Sarah H M Reuvers, Jan Groen, Jeroen R Scheepe, Lisette A 't Hoen, David Castro-Diaz, Bárbara Padilla-Fernández, Giulio Del Popolo, Stefania Musco, Jürgen Pannek, Thomas M Kessler, Marc P Schneider, Gilles Karsenty, Veronique Phé, Rizwan Hamid, Hazel Ecclestone, Bertil F M Blok
Department of Urology, Erasmus MC, Rotterdam, The Netherlands., Department of Urology, Hospital Universitario de Canarias, Universidad de La Laguna, Tenerife, Spain., Department of Neuro-Urology, Careggi University Hospital, Florence, Italy., Department of Neuro-Urology, Swiss Paraplegic Center, Nottwil, Switzerland., Department of Neuro-Urology, Spinal Cord Injury Center & Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland., Department of Urology, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille University, Marseille, France., Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique- Hôpitaux de Paris, Paris 6 University, Paris, France., Department of Neuro-Urology, London Spinal Injuries Centre, Stanmore, United Kingdom.