Condition-Specific Quality of Life 24 Months After Retropubic and Transobturator Sling Surgery for Stress Urinary Incontinence

Abstract

Aims To compare quality of life (QoL) and factors associated with QoL change after retropubic (RMUS) and transobturator (TMUS) midurethral slings using the Incontinence Impact Questionnaire, (IIQ) and the International Consultation on Incontinence Questionnaire (ICIQ). Methods Five hundred ninety seven women in a multicenter randomized trial of RMUS vs. TMUS were examined. The IIQ and ICIQ were obtained at baseline, 12 and 24 months. Repeated measures analysis of variance tested for differences by treatment group over time. Multivariable analysis identified factors associated with QoL change at 12 months post- operative, controlling for treatment group and baseline QoL. Results Improvement in IIQ was associated with: treatment success, younger age, improvement in stress incontinence (SUI) symptom severity and bother (all p < 0.05). Improvement in ICIQ was associated with treatment success, younger age, improvement in SUI symptom severity and bother, lower body mass index and no re-operation (all p < 0.05). Improvement of the IIQ was stable over time (p =0.35) for both treatment groups (p=0.66) whereas the ICIQ showed a small but clinically insignificant decline (p=0.03) in both treatment groups (p=0.51). Conclusions Postoperative QOL was improved after RMUS and TMUS. Measures of QOL functioned similarly, although more surgically modifiable urinary incontinence factors predicted improvement with the IIQ.

The minimum important difference for the International consultation on incontinence questionnaire-Urinary incontinence short form in women with stress urinary incontinence

“…We defined the MID as the difference in ICIQ‐UI SF scores between those who were “better” and those who demonstrated “no change”. Since this 25% reduction was arbitrarily chosen, we also analyzed ≥75% reduction in IE on the 7‐day diary . The PGI‐I scale is a self‐rated assessment of change after treatment with seven response levels ranging from “very much worse” to “very much better.” We used the difference in mean ICIQ‐UI SF scores between patients reporting “very much better” and all other responses.…”

Treatment success of transobturator tape compared with tension free vaginal tape for stress urinary incontinence at 24 months: A randomized controlled trial

“…Bladder perforation was found to be the most commonly reported complication for TVT in studies comparing TVT with TOT [5,14,19]. In addition, our data revealed that TVT had a non-statistically significant higher incidence of UTI and voiding dysfunction (assessed by urine flow test at 24 months).…”

The effect of major depression on quality of life after surgery for stress urinary incontinence: a secondary analysis of the Trial of Midurethral Slings

“…26 The mean change in the ICIQ after surgery in TOMUS was a decrease of 10.3 (AE5.0). 29 We also assumed an existing rate of depression in the general population to be 18% in developed countries. 1 With a fixed sample size of 526 subjects, the study had >95% power to detect a clinically relevant difference in incontinence-specific quality of life.…”