The incontinence severity index (ISI) consists of two questions, regarding frequency and amount of leakage. It categorizes urinary incontinence (UI) into slight, moderate, severe, and very severe. The purpose of this study was to test its validity. The index was compared with the results of pad-weighing tests performed by 200 incontinent women referred to a hospital clinic and 103 at a primary care incontinence clinic. Inconvenience was scored by a six-level Likert scale. Mean pad-weighing results (grams per 24 hours, 95% confidence intervals) were 7 (4-10) for slight, 39 (26-51) for moderate, 102 (75-128) for severe, and 200 (131-268) for very severe UI. Spearman's correlation coefficient for pad-weighing results and severity index was 0.58 (p<0.01), and inconvenience increased significantly with increasing severity. The ISI demonstrated good criterion validity against 24-h pad tests. Good construct validity was indicated by a clear link between ISI and inconvenience.
The overall success rate was significantly higher in the laparoscopic subtotal hysterectomy plus cervicopexy group, compared with the laparoscopic sacral hysteropexy group.
We present a technique that allows postoperative adjustment of the sling tension in female patients with urinary stress incontinence (USI). Twenty-one female patients with urodynamically proven USI were prospectively evaluated. Subjective and objective evaluation was made preoperatively, 6 months postoperatively and yearly thereafter. Mean age was 63.5; mean parity was 2.3. All patients were postmenopausal and 13 (62%) had had previous surgery for USI. The operating time was 32 minutes (range 25-45). At a mean follow-up of 12 months (6-25), 19 patients (90.5%) were very satisfied. Two patients (9.5%) were considered failures but subjectively were satisfied and refused readjustment. One patient (4.7%) developed 'de novo' detrusor instability. In conclusion, this is a sling procedure for patients with previous failed surgery and those with intrinsic sphincter deficiency (ISD) with the peculiarity that the sling tension can be regulated postoperatively. The readjustment can be made in the office, months or even years after the procedure.
Prevalence of urinary symptoms suggestive of Overactive Bladder is high in this study, in accordance with data from international studies. Urinary urgency, symptom which defines the pathology, is more prevalent in Spanish women than men. Further studies are needed to better assess OAB impact in the Spanish general population.
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